LECTURB£M:;y\\  X 

,  •  •  .  • 

•  •  .  :  •  •  • 


ON 


lift*  Redial  gisfcmr 


OF  THE 


Philadelphia  Alms  House. 


Delivered  at  the  Opening  of  the  Clinical  Lectures, 


October  15th,  1862, 


BY 

D.  HAYES  AGNEW,  M.  D. 


PUBLISHED  BY  REQUEST  OP  THE  BOARD  OP  GUARDIANS. 


PHILADELPHIA: 
HOLLAND  &  EDGAR,  PRINTERS, 
54  North  Eighth  Street, 

1862. 


I  am  indebted  to  the  Board  of  Guardians  for  free  access  to  the 
records  of  the  House ;  to  Doctors  Girvin  and  Benton,  Resident 
Physicians  of  the  Philadelphia  Hospital,  for  valuable  assistance  in 
searching  these  records ;  to  Mr.  Samuel  Hazzard,  Secretary  of  the 
Philadelphia  Historical  Society,  for  information  which  the  works 
of  that  library  supplied ;  to  Mr.  Mickley,  whose  rare  collection  o^ 
old  works  is  unsurpassed  ;  to  Professors  Jackson  and  Hodge,  and 
Doctors  Gerrhard  and  Stille,  whose  acquaintance  with  matters  per¬ 
taining  to  the  subjects  treated  on,  proved  of  much  consequence  in 
enabling  me  to  ascertain  facts  connected  with  subjects  on  which  ^ 
written  documents  were  silent,  and  to  Mr.  Cavender,  whose  industry 
in  arranging  the  records  is  most  praiseworthy. 


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LECTUBE 


Gentlemen  : 

I  am  before  you  to-day  by  appointment  of  the  medical  board,  to 
discharge  a  service  preliminary  to  the  opening  of  the  annual  Course 
of  Clinical  Lectures  in  this  hospital.  For  some  time  I  have  been 
engaged  in  gathering  material  from  a  great  variety  of  sources, 
written  and  unwritten,  to  secure  the  history  of  the  Philadelphia  A\m 
House  from  oblivion,  if  not  utter  loss.  The  field  is  extensive  and 
interesting,  though  its  paths  have  been  much  obscured  hy  the  de¬ 
cay  of  time.  So  interwoven  is  it  with  the  secularities  of  Phila¬ 
delphia,  that  no  history  of  this  city,  Civil,  Political,  or  Professional, 
would  be  complete  without  it. 

The  Medical  history  of  the  Philadelphia  Alms  House  covers  a 
period  of  one  hundred  and  twenty  years,  during  which  time  it  has 
been  located  in  three  different  positions.  First,  on  the  square  be¬ 
tween  Spruce  and  Pine,  and  Third  and  Fourth  streets, — at  that  time 
called  the  Green  Meadows;  next  on  the  square  between  Spruce 
and  Pine,  and  Eleventh  and  Twelfth  streets,  long  known  as  the 
Society  Grounds;  and  last  on  the  west  side  of  the  Schuylkill  river, 
where  we  are  assembled  to  day. 

This,  gentlemen,  is  the  oldest  hospital  on  this  continent.  Proud 
in  his  history  of  Pennsylvania,  a  work  justly  esteemed  for  its  re¬ 
search,  says  the  Philadelphia  Alms  blouse  was  of  a  later  date  than 
the  Pennsylvania  Hospital,  the  origin  of  which,  was  in  1853.  This  is 
a  mistake.  In  1742  it  was  fulfilliog  a  varied  routine  of  beneficent 
functions  in  affording  shelter,  support  and  employment  for  the  poor 
and  indigent,  a  hospital  for  the  sick,  and  an  asylum  for  the  idiotic, 
the  insane,  and  the  orphan.  It  was  thus  dispensing  its  acts  of  mer¬ 
cy  and  blessing,  when  Pennsylvania  was  yet  a  province,  and  her  in¬ 
habitants  the  loyal  subjects  of  Great  Britain,  more  than  twenty 
years  before  a  school  of  medicine  was  founded  in  this  city,  and  in¬ 
deed  before  most  of  the  great  events  which  have  given  the  Ameri¬ 
can  people  a  historical  importance  among  the  nations  of  the  earth. 


2.  G  12.0 

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4 


Who^ere*  t'h/ first. physicians  appointed  to  attend  the  Philadelphia 
.Alflig/Hoisse,,  and’  at -"what  period  were  they  assigned  to  this  duty? 
These'  are-  questions,,  so  far  as  I  know,  which  cannot  be  ascertained 
either  from  record* or  tradition.  In  1768,  and  probably  much 
earlier,  Doctor  Cadwallader  Evans,  and  Doctor  Thomas  Bond,  were 
the  medical  appointees;  and  on  the  18th  of  May,  1769,  we  have  a 
formal  announcement  of  their  re-election.  The  institution  at  this 
early  period  contained  two  hundred  and  forty  six  inmates,  and  each 
of  the  medical  attendants  received  fifty  pounds  per  annum,  and  were 
required  to  supply  such  medicines  as  were  needed  by  the  sick. 
Dr.  Bond  studied  his  profession  at  home  and  abroad;  was  the  first 
surgeon  and  physician  to  the  Pennsylvania  Hospital,  in  which  in¬ 
institution,  as  early  as  1769  he  delivered  lectures  on  clinical  medicine 
and  surgery.  Doctor  Cadwallader  Evans  was  one  of  the  first  pupils 
of  Doctor  Bond.  In  order  to  finish  his  education  he  sailed  for  Ed¬ 
inburgh,  but  the  vessel  while  on  the  voyage  was  taken  by  a  Spanish 
privateer,  and  carried  to  Hayti,  where  he  remained  between  two  and 
three  years  before  being  able  to  renew  the  voyage  for  the  Scotch 
metropolis,  then  the  great  centre  of  medical  instruction.  It  was 
after  his  return  from  Scotland  he  became  officially  connected  with 
the  Alms  House.  That  the  medical  police  of  the  House  was  not  of 
the  strictest  character,  may  be  inferred  from  the  fact  that  a  number 
of  persons  were  in  the  habit  of  visiting  the  institution,  assuming  to 
be  Doctors,  and  volunteering  their  services  to  the  unfortunate  sick. 
This  irregularity  continued  unquestioned  for  some  time,  until  many 
of  the  patients  had  suffered  very  great  injury,  and  no  small  amount 
of  discredit  brought  upon  the  management  of  the  House.  A  reso¬ 
lution  was  at  length  introduced  and  passed  by  the  board  of  managers, 
permitting  no  one  to  prescribe  except  the  regular  appointees,  and 
requiring  them  to  visit  the  hospital  oftener  and  with  more  regularity. 
At  this  period  the  invaluable  discovery  of  Jenner  was  unknown  to 
the  medical  world,  and  the  only  method  capable  of  diminishing  the 
horrors  of  small  pox  was  the  induction  of  the  disease  by  inoculation, 
after  a  careful  previous  preparation  of  the  system  for  its  reception. 
Singular  as  it  may  appear,  there  were  many  who  regarded  the  prac¬ 
tice  not  only  improper,  but  positively  sinful.  I  remember  a  few 
years  ago,  whilst  sitting  in  one  of  our  city  churches,  taking  up  a 
bible  which  bore  on  the  fly  leaf  the  inscription,  over  the  signature  of 
the  owner,  “  opposed  to  corporation  and  inoculation.”  In  1771  the 
institution  contained  a  number  of  destitute  children  who  had  never 
had  an  attack  of  variola.  For  their  own,  as  well  as  the  safety  of 


5 


the  other  inmates,  Doctor  Evans  called  the  attention  of  the  man¬ 
agers  to  this  fact,  and  proposed  they  should  be  protected  by  inocula¬ 
tion.  The  board  acquiesced  in  the  suggestion,  provided  the  house 
should  be  subjected  to  no  expense,  other  than  the  medicine  required 
for  their  subsequent  treatment.  Twenty-one  of  these  children  were 
separated  from  the  general  mass  for  this  purpose,  all  of  whom  perfectly 
recovered.  In  the  month  of  February  1778,  there  were  forty  others 
subjected  to  a  similar  course  with  a  like  result. 

In  1772  a  proposition  was  made  to  the  managers  to  extend  the  use¬ 
fulness  of  the  House  by  the  admission  of  students,  and  an  increase 
in  the  number  of  medical  attendants.  This  proposition  included  an 
oiler  of  gratuitous  service,  the  institution  being  only  at  the  expense 
of  purchasing  the  medicines  required  for  the  sick.  On  the  25th  of 
March  1774,  the  desired  addition  to  the  Medical  corps  was  effected 
by  the  election  of  Doctor  Adam  Kuhn,  Professor  of  Materia  Medica 
and  Botany,  in  the  Medical  College )  Doctor  Benjamin  Bush,  who 
held  the  chair  of  Chemistry  in  the  same  institution  ;  Doctor  Samuel 
Duffield,  one  of  the  ten  Alumni  who  received  the  first  Medical  De¬ 
grees  conferred  in  this  country,  (21st.  June,  1768,)  and  Doctor 
Girardus  Clarkson.  An  additional  physician,  Doctor  Thomas  Parke, 
was  added  to  the  number,  March  25th,  1774.  This  probably  is 
the  origin,  in  this  country,  of  gratuitous  professional  service  to 
public  institutions,  which  has  become  so  general  at  the  present  day, 
and  which  I  conceive  operates  disadvantageously  to  both  he  who 
dispenses,  and  he  who  receives.  To  advocate  such  a  sentiment 
brings  no  odium  on  the  profession.  It  requires  no  argument  from 
me  to  vindicate  our  calling  from  the  charge  of  selfishness.  It  is  not 
saying  too  much  when  we  venture  the  assertion,  that  among  the 
professions  there  are  none  which  contribute  so  largely  their  free  will 
offerings  for  the  relief  of  human  suffering,  or  which  furnish  so  many 
examples  of  disinterested  and  unselfish  benevolence  as  our  own. 

I  cannot  refrain  here  from  relating  an  anecdote  somewhat  apjoropos 
to  this  subject.  The  late  professor  Chapman,  while  discharging  the 
clinical  duties  of  his  chair  in  the  University  of  Pennsylvania,  had 
brought  before  him  a  poor  Irish  woman  who  had  applied  for  advice. 
The  Doctor  made  a  careful  examination  of  her  case,  ordered  a  pre¬ 
scription  to  be  made  out,  and  bade  her  in  a  kindly  tone  to  retire. 
With  great  simplicity  of  manner  she  tendered  a  compensation,  which 
on  being  declined,  in  an  air  of  mingled  surprise  and  doubt,  she  ex¬ 
claimed  :  “  Take  the  trifle,  my  jewel,  for  its  yourself  must  be  after 
living  “  Ah  !  my  good  woman/’  said  the  Doctor,  in  his  own  inimi- 


6 


itable  way,  u  We  Doctors  are  a  very  peculiar  people,  we  look  for  our 
reward  hereafter.” 

To  every  American  the  year  1776  is  full  of  historic  importance.. 
A  period  when  our  revolutionary  sires,  men  of  large  hearts,  broad 
minds,  and  self-sacrificing  spirits,  were  freely  spending  their  blood, 
treasure,  and  wisdom,  to  establish  a  national  independence  and  gov¬ 
ernment,  which  their  children  are  to  day  in  a  spirit  of  unparalleled 
venture,  rending  to  pieces. 

On  the  5th  of  September,  1776,  the  Council  of  Safety ,  through 
its  President,  Thomas  Wharton,  Jun.,  addressed  a  note  to  the  man¬ 
agers  of  the  Bettering  House,  as  it  was  often  styled,  asking  permis¬ 
sion  for  the  Quarter  Master,  (Deputy)  General,  to  quarter  in  the 
institution  a  number  of  the  Continental  militia,  who  were  very 
sick  with  dysentery.  This  was  strenously  opposed  both  by  the  man¬ 
agers  and  the  medical  attendants,  as  calculated  to  endanger  the 
health  of  the  house.  They  had,  on  former  occasions  suffered  great¬ 
ly  from  the  prevalence  of  putrid  sore  throat  and  small  pox;  and  had 
been  compelled  to  move  many  of  these  cases  to  private  lodgings  in 
order  to  stay  their  fatal  progress;  and  in  justice  to  the  helpless  and 
infirm  inmates — most  of  whom  possessed  little  ability  to  with¬ 
stand  disease,  they  naturally  objected  to  the  introduction  of  an  ele* 
ment  of  danger,  such  as  malignant  disentery,  the  scourge  of  camps 
would  constitute.  As  all  military  government  tends  to  despotisnq 
the  application  was  merely  to  maintain  a  semblance  to  the  legitmate 
forms  of  propriety.  This  is  quite  natural  and  proper,  when  public 
necessity  becomes  paramount  to  personal  considerations ;  and  ac¬ 
cordingly  the  council  ordered  Col.  Francis  Guerney,  on  the  23d  of 
October,  to  take  military  possession  of  the  Alms  House,  for  the  sick 
soldiers.  No  alternative  was  left  but  to  make  the  best  of  the  un¬ 
pleasant  position  forced  upon  them.  The  poor  were  transferred  to 
the  west  building,  and  these  soldiers  were  placed  in  the  south  east 
wing  of  the  House  of  Employment,  arresting  entirely  the  indus¬ 
trial  operations  of  the  establishment.  They  retained  possession  of 
this  apartment  until  the  British  took  possession  of  the  city  in 
1777,  when  they  were  removed.  This  removal,  however,  in  no  way 
relieved  the  managers  from  embarrassment,  as  shortly  after,  in  the 
month  of  October,  the  entire  east  wing  was  appropriated  for  the 
sick  belonging  to  the  Kings’  troops  under  General  Howe.  For 
fear  they  might  in  like  manner  appropriate  the  west  wing  also,  the 
managers  waited  on  Joseph  Galloway,  to  secure  his  influence  with 
the  General,  to  prevent  an  occurrence  which  must  entail  so  great 


T 


distress  on  the  poor- — its  inmates  at  this  time  being  of  the  most  help¬ 
less  description.  Joseph  Galloway,  was  a  lawyer  of  distinction  and 
wealth,  Speaker  of  the  Provincial  Assembly.  In  our  struggle,  he 
took  the  royal  side  of  the  question,  and  became,  under  the  sanction 
of  the  British  Commander,  the  General  Superintendant  of  the  city. 
When,  however,  the  cause  of  the  Colonies  brightened,  and  Howe  was 
obliged  to  evacuate  Philadelphia,  he  was  compelled  to  follow  his 
master,  his  estates  were  confiscated,  his  fortune  melted  away,  and 
he  was  obliged  to  accept  a  Secretaryship  to  the  Commander-in- 
Chief.  It  was  therefore  in  consequence  of  his  royal  proclivities,  the 
managers  sought  his  aid.  They  were  referred  by  him  to  Doctor 
Stuart,  Surgeon  General  of  the  British  Military  Hospital,  who 
promised  unless  an  emergency  should  arise,  to  accede  to  their  re¬ 
quest.  It  was  but  a  short  time  after  this,  in  November,  at  9  o’clock 
at  night,  when  the  poor  were  almost  destitute  of  food,  the  barrack 
master  called  on  two  of  the  managers,  ordering  them  to  clear  the 
house  for  the  reception  of  the  King’s  troops.  The  Board  met  the 
next  morning,  and  after  a  short  deliberation,  refused  to  comply  with 
the  unreasonable  and  cruel  demand.  On  hearing  their  decision, 
the  British  official  proceeded  at  once  to  remove  the  inmates — about 
two  hundred  in  number,  of  miserable,  decrepid,  half  starved  crea¬ 
tures.  As  they  would  soon  have  perished,  exposed  to  the  rigors  of  a 
November  air,  the  managers  succeeded  in  securing  quarters  for  them, 
some  in  the  Free  Masons  old  Lodge — still  standing  in  Filbert,  above 
Eighth  street;  some  in  the  Friends’  Meeting  House;  and  others  in 
Carpenter’s  Hall,  off  Chesnut,  above  rl bird  street;  where  they  were 
maintained  until  the  last  days  of  June  1778,  when  the  invaders 
having  left  the  city,  they  were  removed  back  to  their  old  home. 
The  exposure  and  deprivation  attending  their  ejectment,  was  fol¬ 
lowed  by  a  heavy  mortality,  as  only  eighty-two  of  the  original  two 
hundred  survived,  to  re-enter  their  former  quarters. 

In  1777  Doctors  Benjamin  Bush  and  Clarkson,  resigned  their 
posts,  and  the  three  remaining  members  were  requested  by  the  Board 
of  managers,  either  to  occupy  their  terms  of  service,  or  to  choose  sub¬ 
stitutes  ;  the  former  of  which  they  concluded  to  do.  No  alteration 
in  this  arrangement  was  made  until  the  29th  of  April,  1779,  when 
a  proposition  was  made  by  Doctors  Glentworth,  Jackson,  and 
Duffield,  to  attend  the  sick  of  the  institution,  charging  only  for  the 
medicines  used  in  their  treatment.  From  the  25th  of  March  1780, 
we  may  date  the  origin  of  the  system  of  Out  Door  medical  relief  as 
a  part  of  the  benevolent  operations  of  the  managers  of  the  poor. 


8 


In  order  that  such  aid  might  be  furnished,  Doctors  Hutchison  and 
Wilson,  were  requested  to  attend  and  prescribe  for  those,  who, 
although  not  inmates  of  the  institution,  were  yet  dependent  on  its 
resources  for  professional  aid.  From  this  small  beginning,  in  which 
two  gentlemen  were  able  to  meet  all  the  demands  of  the  city,  have 
arrisen  eleven  districts,  requiring  twenty-four  physicians,  who, 
for  a  very  small  compensation,  dispense  an  amount  of  professional 
relief  truly  wonderful.  In  passing  over  the  records  of  this  depart¬ 
ment  it  is  pleasant  to  find,  that  at  one  time  or  another,  almost  every 
name  of  note  in  the  ranks  of  our  profession,  is  found  among  those 
who  have  labored  in  this  sphere  of  humble  usefulness,  and  no 
doubt,  not  a  few  of  them,  laid  the  foundation  of  their  future  reputa¬ 
tion,  while  thus  engaged  in  visiting  the  sick  poor  in  the  secluded 
lanes,  and  alleys  of  this  metropolis.  No  man  can  long  labor  in 
such  a  field,  in  daily  contact  with  a  class,  whose  sufferings  are 
greatly  increased  by  the  absence  of  so  much  which  serves  in  the 
more  fortunate  to  alleviate  the  presure  of  disease,  without  feeling  all 
the  sympathies  of  his  heart  unlocked,  and  becoming  a  wiser  and 
better  man. 

On  the  7th  of  February  1781,  Dr.  Bond,  who  it  seems  had  no 
connexion  with  the  house  after  the  year  1779,  being  at  this  time 
Medical  Purveyor  of  the  United  States  Army,  applied  to  the  man¬ 
agers  for  the  east  wing  of  the  building,  which  had  shortly  before 
been  occupied  by  the  Board  of  War,  to  accommodate  a  number  of 
British  prisoners  who  were  very  ill  at  that  time  in  the  jail.  This 
request  was  granted,  by  his  agreeing  in  behalf  of  the  government, 
to  pay  a  monthly  rent  of  one  hundred  dollars,  hard  money.  For 
some  time  after  1781,  Doctor  Samuel  Duffield  seems  to  have  been 
the  only  physician  attatched  to  the  institution,  giving  his  attention, 
under  a  contract  based  on  his  own  proposition,  to  attend  all  the  in¬ 
mates,  and  find  the  necessary  medicines,  for  the  sum  of  two  hundred 
pounds  per  annum.  One  of  two  things  is  evident;  either  the  Doctor 
was  fond  of  money,  or  fond  of  work. 

At  this  time  it  was  the  custom  to  have  the  venereal  cases,  and  the 
violent  insane,  treated  at  the  Pennsylvania  Hospital.  In  regard  to 
the  first,  it  was  deemed  necessary  in  accordance  with  the  current 
medical  notions  on  the  subject,  to  subject  every  case  to  a  mercurial 
course,  carried  to  the  extent  of  salivation.  In  the  Pennsylvania 
Hospital,  the  accomodations  for  this,  were  greater,  and  more  complete 
than  those  of  the  Alms  House.  In  addition  to  the  ordinary  expenses  of 
board  and  nursing,  a  fee  wasalwa)s  charged  against  the  Alms  House 


9 


by  the  Physician  under  whose  care  the  case  had  been  treated.  There 
is  a  record  of  two  guineas  for  this  object  being  paid  to  Dr.  John 
Morgan,  one  of  the  two  gentlemen  who  first  established  a  medical 
school  in  America.  In  1782,  the  General  Assembly  passed  an  act 
authorising  the  managers  to  bind  out  all  persons  treated  for  venereal 
disease,  until  the  expenses  were  liquidated  from  the  proceeds  of  their 
labor.  These  expenses,  it  is  presumed,  averaged  about  twenty  four 
pounds,  from  that  amount  having  been  specified  on  the  record,  as 
the  sum  for  which  one  binaing  had  been  made.  Between  the  morti¬ 
fying  annoyance  of  the  disease,  the  salivation  of  the  doctors,  and  the 
limited  apprenticeship;  the  worshipper  at  the  shrine  of  Venus,  paid 
pretty  dearly  for  his  whistle.  In  1788  a  new  organization  of  the 
medical  department  was  made,  by  the  election  of  Doctor  Samuel 
Duffield,  Samuel  P.  Griffitts — who  subsequently  became  professor  of 
Materia  Medica  and  Pharmacy,  in  the  Medical  College  of  Phila¬ 
delphia;  Caspar  Wistar — afterwaids  professor  of  Chemistry  and  the 

Institutes  of  Medicine,  and  still  later  of  Anatomy ;  - Dodgers, 

Girardus  Clarkson,  Michael  Leib,  and  John  Morris.  In  less  than  a 
year  (in  April  1789)  Drs.  Morris  and  Griffitts.  in  consequence  of  their 
private  business,  tendered  their  resignations.  Both  of  these  gentle¬ 
men  were  popular,  and  although  their  official  connexion  with  the 
house  had  been  short,  the  managers,  in  accepting  their  resignations, 
acknowledged  in  a  very  handsome  and  complimentary  manner,  the 
value  of  their  professional  services  to  the  House.  The  same  month 
in  which  Doctors  Griffitts  and  Morris  withdrew,  the  medical  organ¬ 
ization  was  reduced  to  six  members,  by  dropping  Dr.  Rodgers,  and 
electing  Doctor  N.  Waters,  and  Doctor  William  Shippen,  the  latter,  the 
founder  of  medical  teaching  in  this  country.  On  the  29th  of  March, 
1790,  the  managers  addressed  a  communication  to  these  physicians, 
acknowledging  the  value  of  their  services  to  the  poor, and  begging  they 
would  continue  their  several  offices  the  coming  year.  This  letter  no 
doubt  was  designed  to  be  antidotal;  for  only  a  short  time  before 
they  had  refused  a  very  reasonable  request  of  the  medical  atten¬ 
dants,  which  will  receive  its  proper  explanation  when  the  Clinical 
history  of  our  subject  is  reached.  One  month  after,  the  whole  body 
of  physicians  resigned,  the  institute  losing  the  best  medical  talent 
in  the  city. 

Shortly  after  this  event,  Doctors  Duffield  and  Leib  solicited  an 
appointment  to  the  House,  who,  after  their  election,  were  required  to 
become  the  purchasers  of  all  drugs  consumed  by  the  sick.  The 
increase  in  the  population  of  the  Alms  House,  together  with  the 


10 


private  engagements  of  these  gentlemen,  rendered  it  necessary  for 
them  to  ask  some  assistance,  for  which  object  Doctor  Cumming, 

August  the  10th,  1795,  was  appointed  Assistant  Visiting  Physician, 
without  salary.  1, 

Whatever  may  be  thought  of  the  credulity  of  the  present  genera¬ 
tion,  it  is  no  less  clear  the  people  of  1796  were  not  proof  against 
charlatan  imposition.  Every  age  has  had  some  crotchet  on  which 
to  betray  mental  imbecility.  The  whale  must  have  a  tub  with  which 
to  amuse  itself.  At  the  period  above  named,  it  was  Perkinism,  or 
the  cure  of  disease  by  metallic  tractors.  The  most  extravagant 
reports  of  extraordinary  cures  effected  by  this  manipulation  had  been 
bruited  abroad  in  advance  of  the  Doctor’s  arrival  in  Philadelphia. 

The  eyes  of  the  blind  had  been  opened;  the  ears  of  the  deaf  un¬ 
stopped;  the  lame  man  made  to  leap  as  a  hart;  and  in  fine,  a  uni¬ 
versal  catholicon  for  human  disease  and  infirmity  had  at  length  been 
discovered.  On  the  27th  of  February,  the  Visiting  Committee  of 
the  house  reported  having  witnessed  several  successful  operations 
by  Doctor  Perkins,  with  his  metallic  points,  and  had  seen  the  grate¬ 
ful  acknowledgments  of  many  others  who  had  been  subjects  of  his 
new  method;  that  the  hospital  contained  numerous  cases  which 
might  be  benefited  by  his  skill,  and  proposed  that  George  Davis, 
one  of  the  members  of  the  Board,  be  authorized  to  invite  Dr. 

Perkins  to  attend  the  institution  on  the  following  Wednesday,  at  10 
o  clock,  thus  giving  the  other  members  an  opportunity  of  being  pre¬ 
sent  during  his  visit.  The  Doctor  made  his  appearance  on  the  ap¬ 
pointed  day,  and  managed  so  successfully  to  close  the  eyes  of  the 
sage  managers,  as  to  secure  from  them  the  purchase  of  his  patent 
for  the  benefit  of  the  hospital ;  and  this  house  to-day  owns  the  ex¬ 
clusive  right  to  practice  in  Philadelphia  the  cure  of  disease  by  me¬ 
tallic  points. 

Where  is  Perkinism  to-day  ?  that  gigantic  humbug,  which  over¬ 
run  with  unparalleled  rapidity,  towns,  cities,  villages,  and  rural  dis¬ 
tricts,  at  home  and  abroad,  and  was  endorsed  by  three  American  uni¬ 
versities.  Gone  to  the  tomb  of  the  Capulets,  where  every  other  isrfi, 
system,  and  device  of  man,  not  resting  on  a  substratum  of  truth, 
must  sooner  or  later  sink,  never  to  be  unburied  unless  by  the  pick 
of  some  future  Fossilist,  delving  among  the  caput  mortuums  of 
exploded  systems,  for  specimens  of  human  folly,  either  to  adorn  a 
cabinet,  or  point  the  shaft  of  ridicule.  That  Perkinism  could  not 
have  proved  very  efficient  in  the  Philadelphia  Alms  House,  may  be 
inferred  from  the  fact  that  on  the  20th  of  March,  the  sick  had  be- 


11 


come  so  numerous,  as  to  require  an  additional  number  of  physicians, 
to  aid  Doctor  Duffield  and  his  assistant  in  their  labors.  The  gen¬ 
tlemen  selected  by  the  Board,  were  Doctors  Samuel  Clements,  Jr., 
Wm.  Boyce,  and  Samuel  Cooper,  at  a  salary,  each,  of  One  Hundred 
Dollars  annually.  It  would  appear  Doctor  Cooper  declined  the  ap¬ 
pointment,  and  the  corps  remained  without  any  substitute  being 
elected.  They  were  required  to  visit  the  Hospital  three  times  a 
week  ordinarily,  and  of'tener  if  the  state  of  the  sick  demanded  it ; 
two  were  to  attend  together,  and  in  case  an  operation  was  required, 
the  operator  was  to  be  selected  by  a  majority  vote. 

In  the  fall  of  1797,  Doctor  Pleasants  died,  and  on  the  23d  of 
December,  the  same  year,  Doctors  John  Church  and  Thomas  C. 
James,  the  latter  subsequently  Professor  of  Obstetrics  in  the  Uni¬ 
versity  of  Pennsylvania,  were  elected,  the  former  to  supply  the 
vacancy  occasioned  by  death,  and  the  other  in  the  place  unoccupied 
by  Doctor  Cooper. 

Until  1801,  there  were  no  changes  to  notice,  when,  on  the  6th  of 
April  of  this  year,  Doctor  Boyce  tendered  his  resignation;  shortly 
after  which,  Doctor  Elijah  Griffith  was  elected  his  successor.  In 
August,  Doctor  Duffield,  who  seemed  to  be  a  necessary  appurtenance 
of  the  house,  having  been  connected  with  it  for  twenty-nine  years, 
was  dismissed  in  consequence  of  having  furnished  a  certificate  ad¬ 
mitting  a  patient  with  typhus  fever  into  the  institution.  At  this 
time  there  seems  to  have  been  a  very  close  police  exercised  by  Ihe 
managers  over  admissions,  in  consequence,  no  doubt,  of  the  recent 
epidemic  of  yellow  fever  which  had  desolated  so  many  homes,  and 
produced  such  wide  spread  distress,  and  consternation  in  the  com¬ 
munity.  After  the  removal  of  Doctor  Duffield,  the  number  of  medi¬ 
cal  attendants  was  increased,  by  the  election  on  Sept.  7th,  1801,  of 
Doctors  John  Proudfit,  Philip  Syng  Physick — the  father  of  American 
Surgery,  and  Charles  Caldwell,  familiar  to  the  present  generation  of 
medical  men  as  the  author  of  his  own  biography;  a  man  un¬ 
questionably  of  remarkable  intellectual  force,  combined,  however, 
with  such  incongruous  elements  of  character,  as  were  calculated  to 
defeat  the  best  appointed  plans  of  ambition.  These  gentlemen  were 
to  receive  a  salary  of  twenty-five  pounds  per  annum. 

In  1804  a  very  extraordinary  event  occuied  in  view  of  the  very 
amiable  nature  of  doctors  in  general.  This  was  a  quarrel  among  the 
physicians,  originating  mainly  in  a  private  difficulty  between  Doctors 
Caldwell  and  James.  The  dispute  grew  to  such  magnitude,  that 
the  managers,  as  the  shortest  way  to  establish  the  peace  of  the  insti- 


12 


tution,  on  the  9th  of  January,  proceeded  to  the  election  of  a  new 
board,  consisting  of  Doctors  Philip  Syng  Physick,  John  Church, 
Elijah  Griffitts,  John  Rush,  Thomas  C.  James,  Benjamin  Smith 
Barton  and  Samuel  Stewart;  each  of  whom  was  to  receive  the  old 
salary  of  £25,  subject  to  all  reasonable  out- door  calls.  Doctor  Rush 
declined  the  appointment,  and  on  the  19th  of  the  same  month, 
Doctor  James  Reynolds  was  elected  to  take  his  place. 

On  the  17th  of  January,  1805,  the  same  year  in  which  he  was 
elected  to  the  Chair  of  Surgery  in  the  University,  Doctor  Physick 
offered  his  resignation.  Yery  soon  after  its  acceptance,  Doctor  James 
Hutchison  was  appointed  his  successor.  The  latter  gentlemen's 
name  is  associated  with  a  modification  of  the  Desault  splint  for  frac¬ 
tures  of  the  thigh.  His  service  was  of  short  duration,  his  resigna¬ 
tion  being  recorded  three  months  after  the  announcement  of  his 
election.  During  this  year  a  difficulty  occurred  between  the  managers 
and  Dootor  Barton,  in  consequence  of  the  latter  declining  to  attend 
out-door  patients.  Their  views  being  irreconcilable,  the  Doctor  was 
dismissed,  and  to  supply  the  two  vacancies  now  existing,  Doctors  J. 
Cathrall,  and  Peter  Miller  were  selected  by  the  Board. 

It  was  also  during  this  year  Doctor  Church  died.  His  place  was 
occupied  by  the  brilliant,  but  short-lived  John  Syng  Dorsey,  who,  in 
his  brief  career  of  professional  life,  occupied  no  less  than  three  promi¬ 
nent  positions  in  the  medical  department  of  the  University  of  Penn¬ 
sylvania — first  as  an  adjunct  to  Physick ;  then  as  successor  to  Chap¬ 
man  on  materia  medica,  and  last  as  successor  to  Wistar  on  anatomy. 
The  next  change  was  produced  by  the  death  of  Doctor  Reynolds  in 
1807.  After  this  event  an  additional  physician  was  added  to  the 
corps  by  the  election  of  Dr.  Nathaniel  Chapman  to  supply  the  va¬ 
cancy  occasioned  by  the  death  of  Doctor  Reynolds,  and  Doctor 
Joseph  Parrish  to  make  up  the  compliment  of  the  staff. 

On  the  17th  of  November  1809,  a  resolution  was  introduced  and 
adopted  by  the  managers,  constituting  the  medical  officers  of  the 
Alms  House,  a  Medical  Board.  They  were  to  meet  the  first  Monday 
of  every  month,  at  4  o'clock,  P.  M.,  and  report  rules  for  the  govern¬ 
ment  of  the  Hospital  department. 

The  following  year,  1810,  furnishes  us  with  the  first  instance,  so 
far  as  I  know,  of  a  hospital  in  this  country  receiving  a  female  resi¬ 
dent  physician.  On  the  1st  of  July,  a  Mrs.  Lavender  made  appli¬ 
cation  to  be  admitted  into  the  institution,  as  an  Assistant  Midwife, 
in  order  the  better  to  perfect  her  education.  Such  a  charming  name, 
u  Lavender ,"  so  overcome  the  physical  senses  of  the  members  of  the 


13 


board,  that  they  lost  their  intellectual  sense  and  granted  her  petition. 
During  my  term  of  service  in  the  winter  of  1856,  several  women 
from  the  Female  Medical  College  of  this  city,  were  furnished  with 
tickets  to  the  clinical  lectures,  without  my  knowledge.  You  may 
imagine  my  astonishment,  when  entering  the  lecture  room  to  discharge 
the  duties  of  the  hour,  I  saw  seated  on  one  side  of  the  amphitheatre, 
a  number  of  these  misguided  creatures.  I  had  selected  for  the  in. 
struction  of  the  class  on  that  morning,  a  series  of  cases  all  illustra¬ 
ting  some  disease  of  the  genital  organs;  and  as  it  was  now  to  late  to 
recede,  I  proceeded  to  operate  for  phymosis,  and  to  exhibit  and  treat 
some  blooming  specimens  of  chancre.  Notwithstanding  there  were 
a  large  number  of  male  students  present,  and  the  personal  exposure 
necessary  for  the  conduct  of  the  Clinic,  they  never  betrayed  the  slight¬ 
est  evidence  of  shame,  but  sat  with  the  imperturbable  indifference 
of  primeval  innocence.  This,  I  suppose,  some  would  consider  praise¬ 
worthy  and  philosophical,  but  which  I  confess  exhibited  to  me  a  per¬ 
version  of  character,  utterly  below  any  preconceived  views  ever  enter¬ 
tained  of  strong-minded  women.  The  occurrence  was  never  repeated, 
as  I  at  once  addressed  a  letter  to  the  board,  when  their  money  was 
returned,  and  admittance  refused. 

Two  vacancies  occurred  in  1810,  one  by  the  withdrawal  of  Doctor 
Griffitts,  and  the  other  by  the  death  of  Doctor  Stewart.  To  supply 
these,  Doctors  Stewart  and  Joseph  Klapp  were  elected.  On  the 
2nd  of  September,  1811,  Doctor  Dorsey  tendered  his  resignation, 
and  on  the  9th  of  the  same  month,  was  succeeded  by  Doctor  Thomas 
Hewson. 

The  service  of  the  various  gentlemen  now  connected  with  the 
house,  was  so  arranged,  that  one  portion  were  to  attend  to  surgical, 
and  the  other  medical  and  obstetrical  cases.  The  surgical  staff  con¬ 
sisted  of  Doctors  Cathrall,  Miller  and  Parish  ;  the  medical,  of  Doctors 
Chapman,  Stewart  and  Hewson.  Between  the  Managers  of  the 
Philadelphia  Alms  House  and  Pennsylvania  Hospital,  there  existed 
at  this  period,  much  unamicable  temper,  as  well  as  jealousy.  Both 
were  anxious  to  secure  the  patronage  of  medical  students,  and  there¬ 
fore  stood  in  the  attitude  of  rivals.  To  such  a  degree  were  the  minds 
of  the  former  influenced  by  these  feelings,  that  they  were  led  to  pass 
a  resolution  calculated  to  act  prejucicial,  rather  than  favorable  to 
the  prosperity  of  their  institution.  This  resolution  rendered  all 
physicians  or  surgeons  holding  place  in  the  Pennsylvania  Hospital, 
inelligible  to  an  election  in  the  Alms  House.  In  1813  this  measure 
was  re-affirmed,  but  from  being  associated  with  certain  other  matters, 


14 


drew  out  an  opposition,  the  influence  of  which  became  sufficiently 
potential  to  secure  its  repeal.  In  1814,  Doctor  Dorsey  again  became 
a  member  of  the  medical  board,  and  it  was  to  his  personal  influence, 
the  meritorious  poor,  recovering  from  disease,  were  indebted  for  the 
house  carriage  purchased  by  the  managers,  to  afford  to  convalescents 
the  benefit  of  exercise  and  fresh  air. 

In  1815,  in  consequence  of  the  managers  assuming  to  regulate  the 
the  term  of  service  of  the  medical  board,  in  a  manner  not  agreeable 
to  its  members,  Doctor  Chapman  resigned,  and  was  succeeded  on  the 
8th  of  May,  by  Doctor  Joseph  Klapp.  The  obstetrical  department 
having  been  placed  exclusively  under  the  control  of  Doctor  James, 
its  duties  necessarily  absorbed  more  time,  than  was  compatible  with 
the  proper  discharge  of  other  engagements,  and  at  his  request,  on 
the  2nd  of  Nov.,  1818,  Doctor  John  Moore  was  elected  Associate 
Obstetrician  to  the  house. 

In  1818,  Doctor  Dorsey,  after  a  few  days  illness,  terminated  his 
mortal  career  in  the  35th  year  of  his  age.  By  the  death  of  Dorsey, 
the  profession  lost  one  of  its  noblest  ornaments ;  the  institution,  a 
man  who  reflected  honor  on  its  hospital ;  and  the  poor  a  compassion¬ 
ate  and  devoted  friend.  The  place  thus  made  vacant  by  the  hand  of 
death,  was  filled  on  the  20th  of  November,  by  Doctor  Joseph  Harts- 
horne,  then  among  the  leading  practitioners  in  Philadelphia.  Two 
sons  of  Doctor  Hartshorne,  enjoying  deservedly  high  reputations  as 
men  of  culture  and  position,  perpetuate  the  eminence  of  their  pa¬ 
ternal  ancestor  in  our  midst  to-day.  Doctor  Hartshorne’s  connexion 
with  the  house,  continued  until  February  28th,  1820,  when  an  exten¬ 
sive  and  laborious  practice  compelled  him  to  withdraw.  On  the 
same  day  in  which  his  resignation  was  accepted,  Doctor  John  Bhea 
Barton  was  elected,  one  of  the  most  accomplished  and  ingenious 
surgeons  of  this  city,  although  not  now,  it  is  to  be  regretted,  engaged 
in  the  active  duties  of  his  profession. 

It  was  during  this  year,  Doctor  William  Swaim,  the  manufacturer 
of  a  panacea  which  had  acquired  considerable  public  notoriety,  was 
allowed  the  privilege  of  administering  his  patent  medicine  to  several 
patients  suffering  from  certain  specific  ulcers,  and  with  a  degree  of  suc¬ 
cess  which  I  believe  secured  unfortunately  the  endorsement  of  names, 
high  in  the  ranks  of  the  profession.  The  large  fortune  amassed 
by  the  patentee  of  this  medicine,  may  be  said  in  a  great  measure 
to  have  resulted  from  the  circumstances  attending  this  experiment 

In  February  1821  Doctor  Moore  resigned,  and  Doctor  Henry  Neill 
was  elected,  first  as  Assistant  Obstetrician  to  Doctor  James,  and 


15 


afterwards,  in  March,  to  equal  rank  with  his  colleague.  Very 
shortly  after,  Doctor  James,  whose  service  to  this  charity  extended 
over  twenty-five  years,  declined  longer  to  discharge  the  duties  of 
obstetrician,  and  on  the  5th  of  March  1821,  Nathan  Shoemaker 
assumed  the  labors  of  this  department.  This  year  the  addition  of 
two  surgeons  and  two  physicians  to  the  medical  board  was  sanc¬ 
tioned  by  the  managers,  which  in  connexion  with  the  resignations 
of  Doctors  Parrish  and  Rush,  the  same  year,  left  four  places  to  be 
supplied,  and  to  which  Doctors  William  Gibson,  George  McClellan, 
Samuel  Colhoun,  and  Wm.  P.  C.  Barton  were  chosen — all  men 
holding  high  rank  among  the  magnates  of  American  Surgery  and 
Medicine. 

During  1822  the  leaven  of  discord  again  commenced  working 
among  the  members  of  the  medical  corps,  and  finally  attained  such 
proportions  as  to  demand  the  interference  of  the  managers,  who  passed 
a  resolution  to  dispense  with  the  services  of  the  board.  This  occur¬ 
red  on  the  12th  of  August,  and  on  the  26th  they  proceeded  to 
select  a  new  body,  which  consisted  of  Doctors  Samuel  Jackson, 
Joseph  Klapp,  John  K.  Mitchell,  and  Richard  Harlan,  to  serve  as 
physicians.  Doctors  John  Rhea  Barton,  William  Gibson,  William 
E.  Horner,  and  J.  V.  O.  Laurence,  as  Surgeons,  and  Doctors  Henry 
Neill,  and  Nathan  Shoemaker,  obstetricians.  Doctor  Klapp  only 
retained  his  connexion  with  the  house,  until  September,  when  he 
was  succeeded  by  Doctor  Nathaniel  Chapman.  Doctor  Laurence, 
who  was  one  of  the  most  indefatigable  workers,  especially  in  morbid 
Anatomy,  was  attacked  with  the  prevailing  fever  of  1822,  not¬ 
withstanding  which  he  very  imprudently  continued  to  discharge  his 
his  professional  labors,  until,  after  an  operation  at  the  institution,  he 
found  himself  utterly  exausted,  was  taken  home  in  the  carriage  of  a 
friend,  and  a  few  days  after  expired.  After  the  death  of  Laurence, 
Doctor  Harlan  was  transferred  to  the  Surgical  staff,  and  Doctor 
Hugh  L.  Hodge  elected  to  the  vacancy  thus  created  in  the  medi¬ 
cal  department.  In  1827  Doctor  Shoemaker  declined  longer  acting 
as  obstetrician,  and  on  the  3d  of  September  was  succeeded  by 
Doctor  Lukens.  This  year  indeed  was  rather  remarkable  for  changes 
in  the  medical  organization.  Doctors  Mitchell  and  Lukens  re¬ 
signed,  and  were  replaced  by  Doctor  Samuel  George  Morton,  the  dis¬ 
tinguished  naturalist,  and  Doctor  Ellis.  The  latter  gentleman  main¬ 
tained  his  connexion  with  the  Alms  House  until  1831,  when  he 
was  removed  by  death,  and  on  the  2nd.  of  May  of  the  same  year 
Doctor - Beattie,  was  selected  to  fill  the  vacancy. 


16 


la  March  1828,  an  act  had  passed  the  Legislature  of  Pennsylva¬ 
nia,  providing  for  the  erection  of  a  new  Alms  House,  and  the  sale  of 
the  old  one.  It  further  provided  for  the  construction  of  a  hospital, 
not  to  be  erected  beyond  Schuylkill  Eighth,  now  called  15th  street. 

The  Medical  Board  pressed  the  building  of  this  hospital  strongly  on  0 

the  Managers,  believing  its  removal  to  the  west  side  of  the  Schuyl¬ 
kill  would  destroy  its  value  as  a  Clinical  School.  Their  efforts,  how¬ 
ever,  proved  unavailing,  as  the  enterprise  was  calculated  to  involve  a 
very  large  outlay  of  money. 

On  the  30th  of  April,  1832,  Doctor  Chapman  gave  up  his  posi¬ 
tion,  and  was  succeeded  by  Doctor  Jacob  Randolph.  Up  to  this 
period  Doctor  Horner  had  been  serving  as  physician,  but  when 
Doctor  Randolph  became  a  member  of  the  board,  they,  by  mutual 
agreement  exchanged  situations,  Surgery  being  more  in  harmony 
with  the  tastes  of  the  former.  Almost  three  years  elapsed  before 
another  change  is  recorded  ;  or  until  March  16th  1835,  when  Doc¬ 
tor  Neill  resigned,  and  Doctor  Casper  Wister  Pennock,  was  elected, 

Doctor  Pennock  was  a  highly  accomplished  physician,  and  this  hos¬ 
pital  furnished  to  him  a  field  for  those  observations  on  the  heart, 
which  were  afterwards  presented  in  a  volume  to  the  medical  world. 

An  earnest  and  untiring  worker,  he  was  soon  laid  aside  from  the 
activities  of  a  profession  which  he  dearly  loved,  and  although  still 
living,  is  the  victim  of  a  hopeless  paralysis. 

On  the  13th  of  October  1835,  Dr.  William  H.  Gerhard  was  elec¬ 
ted  one  of  the  physicians.  The  Doctor  had  enjoyed  as  a  resident 
pupil  the  practice  of  the  house  for  four  years,  namely  in  1828— ’29, 

;30  and  *31.  It  was  while  acting  in  this  capacity  in  1829,  he  per¬ 
formed  those  experiments  on  the  Endermic  application  of  medicines, 
which  were  made  the  subject  of  a  thesis,  and  which  have  been  trans¬ 
lated  into  almost  every  language.  It  was  here  where  he  commenced 
the  cultivation  of  physical  exploration  as  a  means  of  diagnosis,  and 
which  entitles  him  to  be  regarded  as  the  father  of  auscultation  and 
percussion  in  America.  It  was  here  in  1836  where  he  made  those 
careful  investigations  in  the  study  of  intestinal  lesions,  which 
clearly  established  the  distinction  between  typhus  and  typhoid  fever.* 

And  it  was  here  where  by  changing  the  stereotyped  method  of  treat¬ 
ing  cases  of  mania-potu,  he  was  instrumental  in  diminishing  the 
mortality  of  such,  fifty  per  cent. 

*  These  papers  may  be  found  in  the  “  American  Medical  Journal  of 
Medical  Sciences”  for  the  year  1837. 


17 


This  year  Mr.  Isaac  Collins,  a  member  of  the  board  of  Guardians, 
offered  a  resolution  to  alter  the  medical  organization,  by  establish¬ 
ing  a  Chief  Resident  Physician,  to  reside  permanently  in  the  house. 
Although  it  was  subsequently  reported  on  as  inexpedient,  yet  it  may 
be  regarded  as  the  germ  of  a  subject,  which  has  at  different  times 
produced  no  small  amount  of  agitation.  On  the  7th  of  October, 
1835,  both  Doctors  Hodge  and  Morton  resigned.  These  vacancies 
were  supplied  by  the  election  of  Doctor  J oseph  Pancoast,  the  present 
eminent  Professor  of  Anatomy  in  Jefferson  Medical  College,  and 
Doctor  William  Ashmead. 

On  the  28th  of  December  of  this  year,  Doctors  Gerrhard  and 
Pennock,  suggested  to  the  Guardians  the  propriety  of  designating 
the  hospital  department  by  some  specific  name,  as  that  of  Alms 
House  could  not  technically  be  regarded  in  the  sense  of  a  hospital. 
When  the  subject  came  up  regularly  before  the  Board,  it  was  moved 
by  a  member — Mr.  Hansel,  that  it  should  be  styled  the  Philadelphia 
Hospital.  This  received  the  sanction  of  a  majority  vote,  and  has 
been  known  under  that  name  ever  since.  In  the  month  of  February 
1837,  Doctor  Pancoast  was  transferred  at  his  request  to  the  surgical 
staff,  a  vacancy  having  taken  place  by  the  withdrawal  of  Doctor 
Randolph.  To  supply  Doctor  Pancoast’s  vacancy  in  the  Medical  de¬ 
partment,  Doctor  N.  Stueardson,  became  a  member  of  the  board.  In 
1837  Doctor  Beattie,  one  of  the  obstetricians,  resigned,  and  Doctor 
William  Brinckle  became  a  member  of  the  board.  Dr.  Stueardson’s 
connexion  with  the  House  did  not  extend  much  over  one  year,  or  until 
May  1838,  at  which  time  Doctor  Robley  Dunglison,  the  present 
distinguished  professor  of  physiology  in  the  Jefferson  Medical  Col¬ 
lege,  was  elected.  The  year  just  passed,  was  remarkable  for  one  of 
those  visitations  of  folly  and  ignorance,  which  seem  periodically  to 
sweep  over  the  country ;  providentally  I  believe,  designed  to  distin¬ 
guish  the  wise  from  the  fools.  In  the  instance  referred  to,  it  was 
Animal  Magnetism; — and  of  course  if  a  patent  medicine  was  to  be 
tested,  or  any  charalatan  maneuvre  to  be  practiced,  the  Philadelphia 
Hospital  was  the  field  in  which  trial  was  to  be  made,  like  a  barber’s 
head,  everlastingly  pulled  for  stray  hairs  to  determine  the  cutting 
qualities  of  his  instrument.  The  resident  pupils,  among  others,  assid- 
ously  laboured  in  the  manipulation  of  patients,  to  determine  its 
value,  until  the  Guardians,  for  fear  the  remedy  should  prove  too  pow¬ 
erful  for  the  constitutions  of  the  poor,  passed  a  resolution  on  the  20th 
of  June  1837,  disallowing  all  further  operations. 


18 


In  December  1838,  two  vacancies  were  made  in  the  board,  by  the 
withdrawal  of  Doctors  Ashmead  and  Harlan,  to  which  Dr.  Charles 
Bell  Gibson,  now  professor  of  Surgery  in  a  Virginia  Medical  Col¬ 
lege,  and  Edward  Peace,  late  Surgeon  to  the  Pennsylvania  Hospital, 
were  elected.  The  next  change  was  the  resignation  of  Doctor 
Brinkle,  in  May  1889,  and  the  appointment  of  Doctor  Robert  M. 
Huston  to  supply  his  place.  Doctor  Gibson  declining  to  serve 
longer  than  the  fall  of  1840,  Doctor  James  M’Clintock,  became 
one  of  the  obstetricians  of  the  house.  In  1841  Doctor  Peace’s  con¬ 
nexion  with  the  medical  board  terminated,  and  on  the  3d  of  May,  of 
the  same  year,  Doctor  Ashmead  again  become  connected  with  the 
hospital.  In  the  following  August  Doctor  M’Clintock  removed  from 
Philadelphia,  and  Doctor  William  H.  Gillingham  became  one  of  the 
obstetricians  to  the  institution. 

In  April  1843,  Doctor  Meredith  Clymer  was  elected  one  of  the 
officers  of  the  house,  and  was,  I  believe,  the  last  member  of  the  old 
board  of  visiting  physicians. 

The  30th  of  June  1845  is  somewhat  memorable  in  consequence 
of  the  culumination  of  a  trouble  which  had  been  developing  for 
some  time.  The  resident  physicians  were  boarded  at  the  table  of 
the  Steward,  where,  as  I  understand,  in  consequence  of  the  want  of 
due  formality,  and  decorum  in  the  destruction  of  an  unfortunate  cock¬ 
roach,  which  had  rashly  taken  a  near  cut  acrossthe  table,  instead  of 
going  round,  these  gentlemen  became  indignant,  and  demanded  of 
the  managers  to  be  transferred  to  the  table  of  the  matron.  Their 
refusal  to  comply  with  this  request  determined  a  unanimous  resigna¬ 
tion,  leaving  the  hospital  unprovided  with  any  medical  assistance. 
The  evening  of  that  day  Doctors  Horner  and  Clymer  attended,  and 
prescribed  for  the  sick.  Here  was  a  “  cassus  belli”  and  the  mana¬ 
gers  promptly  passed  a  resolution  of  dismissal.  With  the  hope  of 
adjusting  these  differences,  and  bringing  about  a  partial  reconcilia¬ 
tion,  a  joint  meeting  was  called  for  July  2nd,  at  which  Doctors  Jack- 
son,  Horner,  Clymer,  Gillinham,  and  Pancoast  attended,  represent¬ 
ing  as  a  committee  the  medical  board.  Dr.  Jackson  who  seems  to 
have  been  the  advocate  in  the  case,  spoke  in  behalf  of  the  com¬ 
mittee,  urging  on  the  managers  to  allow  the  residents  to  remain,  at 
least  until  their  places  could  be  properly  supplied,  and  declining  to 
pass  any  censure,  or  interfere  in  any  way  in  a  matter  of  personal  con¬ 
flict  between  the  residents  and  guardians,  as  foreign  altogether  to 
their  legitimate  jurisdiction.  The  guardians,  however,  were  inexora¬ 
ble,  and  refused  to  recede  from  their  vote  of  dismissal,  thus  forever 


19 


closing  the  door  of  compromise.  The  seceders  after  retiring,  availed 
themselves  of  the  columns  of  the  Ledger  newspaper,  in  which  there 
appeared  a  card,  betraying,  to  say  the  least  of  it,  a  good  deal  of  youth¬ 
ful  indiscretion.  On  the  same  day  of  this  meeting,  Mr.  Flanagan, 
offered  the  following  resolution,  u  Resolved,  That  the  Hospital  Com¬ 
mittee  be  requested  to  inquire  into  the  expediency  of  re-organizing 
the  Medical  department  of  the  house,  and  report  to  this  board. ”  On 
the  21st  of  July,  that  report  was  made;  which,  after  going  over  the 
ground  of  trouble,  recommended  the  abolishment  of  the  medical 
board,  and  the  substitution  of  a  Chief  Resident  and  Assistant 
Resident  Physician,  and  two  Consulting  Physicians  and  Surgeons. 
On  the  15th  of  September,  the  report  was  taken  up  and  passed,  modi¬ 
fied  as  follows  : — “  After  the  1st  of  October  1845,  there  shall  be 
One  Chief  Resident  Physician,  with  a  salary  of  $1800  per  annum; 
one  consulting  Surgeon,  one  consulting  Physician  and  one  con¬ 
sulting  Accoucher,  each  at  a  salary  of  one  hundred  dollars  a 
year.  What  great  results  proceed  from  small  and  unlikely  causes. 
Who  ever  would  have  thought  the  official  existence  of  a  medical 
board,  composed  of  the  ablest  men,  in  their  various  departments,  on 
the  continent,  was  suspended  on  the  life  of  a  contemptible  cock¬ 
roach.  In  this  manner  the  doors  of  the  Philadelphia  Hospital,  as  a 
school  of  instruction,  were  sealed  for  nine  years. 

THE  ADMINISTRATION  UNDER  A  CHIEF  RESIDENT  MEDICAL  OFFICER. 

On  the  6th  of  October  1845,  the  election  took  place  under  the 
new  organization,  by  which  Doctor  H.  S.  Patterson  was  chosen 
Physician-in-Chief;  William  Byrd  Page,  Consulting  Surgeon ;  Mere¬ 
dith  Olymer,  Consulting  Physician,  and  N.  D.  Benedict,  Consulting 
Accoucher.  Three  months  had  not  elapsed  before  the  board  com¬ 
plained  of  the  interests  of  the  Hospital  being  neglected.  Doctor 
Patterson  at  that  time  held  a  professorship  in  the  Pennsylvania 
Medical  College,  and  they  deemed  this  incompatible  with  his  pres¬ 
ent  post.  On  the  9th  of  November  he  resigned.  Doctor  N.  D. 
Benedict  was  eleeted  his  successor,  and  the  office  of  consulting  ac¬ 
coucher  abolished.  In  January  1848,  the  annual  salary  of  one  hun¬ 
dred  dollars  which  had  been  appropriated  to  each  of  the  consulting 
officers,  was  changed,  directing  five  dollars  to  be  paid  for  each  con¬ 
sultation,  and  such  visits  to  be  ordered  only  in  cases  of  absolute  ne¬ 
cessity.  In  February  1850,  Doctor  Benedict  resigned,  after  which, 
on  the  18th  of  this  month,  Doctor - Haines  become  Chief  Resi-- 


20 


dent,  which  position  he  continued  to  hold  until  the  lltli  of  February, 
1853,  when  exchanging  his  profession  for  another,  and  more  lucra¬ 
tive  calling,  he  removed  from  the  city,  leaving  his  place  vacant, 
and  was  succeeded  by  Doctor  J.  D.  Stewart.  In  July  of  1853,  an 
effort  was  made  to  abolish  this  office  and  return  to  the  old  system; 
and  although  it  did  not  prove  successful  as  regards  the  chief  resi¬ 
dent  of  the  hospital,  yet  it  did  prevail,  in  a  degree,  by  dispensing 
wth  the  Assistant  Resident  of  the  Lunatic  Asylum. 

Doctor  Stewart’s  connexion  with  the  house  was  very  short.  His 
health  had  for  some  time  been  gradually  failing,  under  the  progress 
of  an  organic  affection  of  the  liver,  and  which  terminated  his  life  in 
April  1854.  The  office  of  chief  resident  was  now  temporarily  dis¬ 
charged  by  Doctor  Coleman,  then  an  interne  of  the  house,  or  until 
the  1st  of  May,  at  which  time  Doctor  Archibald  B.  Campbell 
was  elected. 


CLINICAL  INSTRUCTION. 

To  Doctor  Thomas  Bond  belongs  the  honor  of  inaugurating  Clin¬ 
ical  teaching  in  this  country,  while  physician  to  the  Pennsylvania 
Hospital  as  early  as  1766.  But  for  the  Philadelphia  Alms  House, 
we  may  claim  the  establishment  of  the  first  obstetrical  clinic.  Stu_ 
dents  of  good  character  were  allowed  to  attend  cases  of  labor,  and 
the  various  stages  of  the  process  were  explained  to  them  by  Doctor 
Bond  or  Evans,  under  whose  personal  direction  these  instructions 
were  conducted,  as  early  as  1770,  and  in  all  probability  much  earlier, 
as  may  be  inferred  from  the  phraseology  of  the  minutes  touching 
this  subject.  In  1772,  the  managers  were  solicited  to  extend  the 
medical  conveniences  of  the  house  for  the  better  accommodation  of 
students,  increased  numbers  of  which  began  to  be  attracted  to  Phil¬ 
adelphia,  from  the  growing  reputation  of  her  medical  school.  A 
part  of  this  plan  was  an  increase  of  the  medical  officers ;  and  at  this 
date,  some  of  the  first  names  in  the  profession  were  associated  with 
the  enterprise,  such  as  Huhn,  Rush,  and  Clarkson ;  but  the  records 
are  too  meagre  to  furnish  any  details  of  the  manner  in  which  these 
public  instructions  were  conducted.  It  was  then  the  most  exten¬ 
sive  hospital  on  the  continent,  containing  about  350  persons,  and 
must  unquestionably  have  contained  much  disease  of  an  interesting 
and  instructive  character.  Where  the  governing  power  of  an  in¬ 
stitution  is  constantly  undergoing  change,  little  stability  or  perma. 
nence  may  be  expected  in  any  plan  or  system  of  education.  Either 
the  hostility  of  some  of  the  managers,  or  more  probable  the  un- 


21 


settled  state  of  affairs  consequent  on  the  revolutionary  struggle,  in¬ 
terrupted  the  medical  instructions  for  some  time  before  1778,  nor  is 
there  any  evidence  that  clinical  lectures  were  delivered  in  the 
Pennsylvania  hospital  for  several  years  subsequent  to  1771,  where 
Doctor  Bond  was  in  the  habit  of  delivering  a  course  as  a  part  of  the 
instruction  of  the  Medical  College.  In  November  1778  the  subject 
was  revived  by  the  students  present  in  the  city.  They  presented  a 
formal  application  to  the  physicians  of  the  Alms  House  for  permis¬ 
sion  to  witness  the  practice  in  that  institution.  Doctors  Rogers  and 
Leib  waited  on  the  board  of  managers  in  their  behalf,  and  pressed 
the  importance  of  such  a  measure  with  great  earnestness.  On  the 
17th  of  November,  the  subject  came  up  formally  before  the  board, 
and  although  there  were  several  altogether  favorable  to  the  propo¬ 
sition,  a  majority  of  the  votes  were  recorded  in  the  negative.  Im¬ 
mediately  after,  the  physicians  renewed  their  application,  and  solicited 
a  personal  conference  with  the  managers.  A  second  meeting  in 
consequence  took  place,  at  which  the  advantages  of  hospital  instruc¬ 
tion  to  the  profession  and  the  community  were  presented  with  re¬ 
newed  cogency  and  sincerity.  They  begged  a  re-consideration  of  the 
subject,  asking  the  body  of  managers  to  concede  at  least  a  proba¬ 
tionary  trial,  and  volunteering  a  personal  responsibility  for  the  good 
conduct  of  the  young  men  in  attendance.  The  plea  was  not  un¬ 
successful  ;  the  vote  was  re-considered,  and  the  house  was  opened  by 
a  majority  of  one  vote,  for  clinical  instruction.  Until  1789  hospital 
teaching  continued  to  be  conducted  under  great  embarrassment,  part¬ 
ly  on  account  of  the  war,  and  partly  from  the  opposition  of  the  hos¬ 
tile  element  in  the  board,  so  that  while  we  cannot  say  it  was  formally 
abolished,  u  de  jure”  yet  it  was  almost  impracticable,  u  de  facto ” 
On  the  5th  of  May  1789,  the  physicians  elected  sent  a  communi¬ 
cation  to  the  board,  in  which  they  took  occasion  to  say,  “  that  inas¬ 
much  as  they  furnished  their  services  to  this  institution  without  ex¬ 
pense  to  the  managers,  they  ought  to  have  such  facilities  offered,  as 
would  make  their  practice  useful  to  the  public.”  Their  meaning 
not  being  sufficiently  explicit,  the  board  asked  an  explanation,  which 
they  received  on  the  4th  of  July;  and  certainly  left  as  little  room 
for  misunderstanding,  as  did  the  immortal  document  of  the  declara¬ 
tion  associated  with  this  day.  On  the  29th  the  managers  framed  a 
communication  for  the  medical  attendants,  full  of  compliment,  ac¬ 
knowledging  their  valuable  services  to  the  sick,  and  assuring  these 
gentlemen  they  will  ever  endeavour  to  make  their  duties  as  agrea- 
ble  as  will  be  consistent  with  the  good  order  of  the  house,  and  the 


22 


delicacy  due  to  the  patients  under  their  charge.  One  month  after, 
all  the  physicians  withdrew  from  the  institution.  For  six  years  the 
subject  was  allowed  to  slumber,  until  October  1795,  when  Doctor 
Gumming,  who  had  been  appointed  one  of  the  visiting  physicians, 
ventured  to  approach  this  hitherto  imperturbable  body,  with  a  re¬ 
quest  to  be  allowed  the  privilege  of  introducing  his  private  students 
to  the  wards  on  the  days  of  his  official  visits.  The  proposition  was 
promptly  rejected,  on  the  ground  of  such  publicity  being  calculated 
to  do  harm  to  the  sick.  In  1803  Doctors  James  and  Church  pro¬ 
posed  to  attend  the  lying-in  ward,  on  condition  they  should  be  allow¬ 
ed  to  have  one  private  pupil  present  at  each  case  of  labor.  The 
application  was  granted,  and  much  invaluable  instruction  was  com¬ 
municated  in  this  responsible  department  of  medicine.  My  father, 
who  was  a  pupil  of  Doctor  James,  was  among  the  number  who  en 
jo}^ed  this  privilege.  The  same  year,  on  the  23d  of  March,  Doctor 
Caldwell  was  allowed  to  introduce  and  instruct  a  select  class  of 
20 — afterwards  40  students — during  his  stated  visits  to  the  medical 
wards,  on  the  condition  of  his  becoming  responsible  for  their  good 
deportment.  Students  at  that  time  were  regarded  with  no  small 
amount  of  suspicion;  and  even  at  the  present,  there  are  not  wanting 
many  persons  who  entertain  toward  them  a  good  deal  of  reserve  and 
distrust.  It  is  a  shocking  thing,  gentlemen,  to  cut  up  dead  people; 
and  one  might  suppose  from  the  horror  with  which  some  people  shun 
you,  that  students  were  in  the  habit  of  eating  them. 

In  September  1817,  through  the  efforts  of  Doctors  James  and 
Church,  the  managers  conceded  the  privilege  to  deliver  clinical  lec¬ 
tures  to  a  class  of  students  twice  a  week,  in  the  green  or  dead  house, 
during  the  winter  season.  Shortly  after  Dr.  Barton  was  permitted  to 
give  instructions  to  his  class  on  the  days  of  his  regular  attendance 
at  the  house.  Every  successive  year  now  removed  more  and  more 
the  prejudices  which  had  so  long  operated  against  the  admission  of 
medical  students.  The  Managers  were  seized  with  an  active  desire 
to  promote  and  foster  a  system  which  contributed  so  largely  toward 
laying  a  solid  foundation  of  medical  usefulness.  Hence,  in  1805, 
the  buildings  for  the  accommodation  of  the  sick  and  the  poor  being 
inadequate  for  their  proper  comfort,  the  administrative  part  of  the 
board  addressed  the  Legislature  by  petition,  soliciting  aid  to  enlarge 
the  house.  In  presenting  their  prayer,  they  rest  their  claims  on  the 
State  in  the  fact,  that  the  charities  of  the  institution  had  not  been 
confined  to  the  city  and  county  of  Philadelphia  alone;  one  fifth  of 
the  inmates  being  from  other  parts  of  the  commonwealth  :  that  the 


23 


Pennsylvania  Hospital,  rich  in  estates,  had  repeatedly  received  assis¬ 
tance  from  the  munificence  of  former  Legislatures,  and  was  at  that 
time  before  the  Assembly  for  help ;  and  yet  its  doors  were  closed 
against  the  poor,  and  more  than  an  equivalent  for  board  and  lodging 
exacted :  that  moreover  the  Alms  House,  containing  over  one  thou¬ 
sand  inmates,  presented  an  extensive  field  for  communicating  med¬ 
ical  instruction  to  students,  attracted  from  all  sections  of  the  country, 
by  the  celebrity  of  the  school.  This  petition  anticipating  extensive 
preparation  for  clinical  accommodations,  was  regarded  by  the  general 
board  as  an  unwarrantable  assumption  of  power  on  the  part  of  the 
managers,  and  produced  a  very  tart  correspondence,  which  I  have 
no  doubt  produced  the  passage  of  the  supplement  to  the  poor  law  of 
1808. 

Until  October  the  25th,  1805,  no  fee  was  demanded  from  those 
attending  the  instruction  of  the  institution  ;  but  at  the  above  date  a 
ticket  was  directed  to  be  issued,  signed  by  the  President  and  Secre¬ 
tary  of  the  Board  of  Guardians,  at  the  price  of  eight  dollars — two 
purchasing  a  perpetual  privilege.  The  office  pupils  of  the  Medical 
officers  were  free  to  attend  without  charge.  In  November,  1806, 
Poctor  James  was  delivering  lectures  still  in  the  green  room,  and 
there  they  continued  to  instruct,  until  1811,  when  the  Surgeons 
connected  with  the  Alms  House,  asked  for  more  suitable  apartments, 
in  which  operations  could  be  performed,  and  thus  remove  from  the 
ward  a  source  of  mischief  to  the  other  sick.  To  correct  this  evil 
the  board  had  the  building  called  the  dye  and  wash-house,  carried  up 
an  additional  story,  fitted  up  as  a  lecture  room,  with  two  adjoining 
wards,  capable  of  holding  each  twenty  or  thirty  patients,  and  here 
were  next  delivered  the  Clinical  lectures. 

During  1813,  the  Managers,  anxious  to  advance  the  reputation 
and  popularity  of  the  house,  were  induced  to  tender  to  any  student 
taking  their  ticket,  the  privilege  of  attending  a  case  of  labor,  and 
to  give  the  proposal  greater  publicity,  it  was  by  their  authority  an¬ 
nounced  in  the  public  papers.  This  scheme  of  indiscriminate  admis¬ 
sion  to  the  ward  of  the  lying-in  department,  brought  out  a  minority 
protest,  which  was  not  only  a  sensible  paper  on  the  subject  of  differ¬ 
ence,  but  which  introduced  and  exposed  the  suicidal  measures  of  the 
board  on  another  matter  closely  allied  with  the  success  of  the  Alms 
House,  as  a  medical  school,  by  making  the  simple  circumstance  of 
holding  an  appointment  in  the  Pennsylvania  Hospital,  a  disqualifica¬ 
tion  for  a  similar  one  in  the  institution  over  which  the  managers 
presided.  They  urged  the  wisdom  of  selecting  the  very  best  talent 


24 


wherever  found,  and  especially  the  propriety  of  seeking  as  many  from 
the  Medical  School  as  possible.  That  the  force  of  this  may  he  un¬ 
derstood,  it  must  be  remembered  every  student  was  required,  as  a  con¬ 
dition  of  graduation,  to  take  a  ticket  in  the  Pennsylvania  Hospital. 
If,  therefore,  they  could  identify  the  interests  of  the  faculty  of  the 
University  with  the  Alms  House,  it  would  in  all  probability  procure 
such  a  modification  of  the  rule,  as  would,  at  least,  leave  it  at  the 
pleasure  of  the  student,  whether  this  ticket  was  taken  at  one  or  the 
other.  This  protest  effected  a  change  of  sentiment  in  the  Board, 
securing  not  only  a  more  circumspect  modification  of  the  obstetrical 
privilege,  but  a  repeal  of  the  law  so  far  as  it  effected  the  eligibility 
of  professional  men  serving  in  a  kindred  institution,  and  on  the  6th 
of  November  1815,  produced  the  very  result  contemplated. 

A  more  noble  spirit  on  the  part  of  the  managers  this  year,  also  led 
to  a  pleasant  interchange  of  civilities  between  these  sister  hospitals. 
The  Steward  was  authorized  to  address  a  note  to  the  Residents 
of  the  Pennsylvania  Hospital,  inviting  them  to  an  operation  to  be 
performed  at  the  Alms  House,  and  this  privilege  was  afterwards 
made  perpetual. 

On  the  5th  of  January,  1818,  a  conference  was  held  between  a 
Committee  of  Trustees  of  the  University,  and  the  Board  of  Guardians, 
with  a  view  of  establishing  more  extended  clinical  teaching  in  the 
Alms  House.  The  number  of  students  had  been  gradually  increas¬ 
ing.  In  1818  there  were  53  in  attendance;  but  the  succeeding 
three  years  being  remarkable  for  the  prevalence  in  the  house  of  ma¬ 
lignant  disease,  had  no  doubt  some  influence  in  diminishing  the 
class,  for  in  1819  it  does  not  appear  there  were  more  than  43,  and 
in  1820  but  22  in  attendance.  In  1822,  however,  the  number  ran 
up  to  110.  This  was  the  year  in  which  Dr.  Barton,  having  been 
allowed  to  convert  the  area  in  the  rear  of  the  centre  building  into  a 
botanic  garden,  was  in  the  habit  of  taking  the  class  among  the 
plants  to  illustrate  the  subjects  of  his  lectures ;  and  the  year  also  in 
which  Gibson,  Barton,  Horner,  Mitchell,  Laurence,  and  Chapman, 
all  accomplished  gentlemen,  learned  and  eloquent  men  in  medicine 
and  surgery,  were  wont  to  pour  forth  the  treasures  of  their  expe¬ 
rience  and  observation.  The  subject  of  a  botanic  garden  on  a  large 
and  liberal  scale,  and  to  be  placed  under  a  scientific  head,  had  been 
a  favorite  idea  with  members  of  both  the  medical  and  managers* 
board,  but  could  not  be  successfully  accomplished.  After  Doctor 
Barton  left  the  board,  the  old  garden  passed  into  the  hands  of  Doctor 
Samuel  Jackson,  by  whose  suggestion  a  green-house  was  constructed 


25 


for  the  more  complete  protection  and  preservation  of  the  plants. 
Between  the  years  1822  and  1828  I  have' no 'data  for  determining 
the  number  of  students  attending  the  clinical  instruction. 

In  1827  it  was  announced  in  the  public  newspap-SB  tbat'easee  of 
recent  fractures  would  be  received  and  treated  in  the  institution. 
The  suggestion  came  from  the  surgical  staff,  and  would  enable  them 
to  furnish  illustrations  of  the  management  of  a  very  important  class 
of  accidents. 

During  1827,  Doctor  Thomas  Harris  asked  the  privilege  of  de¬ 
livering  a  course  of  lectures  on  Surgery  in  the  lecture  room  of  the 
house ;  which  was  granted  by  the  guardians.  This  course  was  didac¬ 
tic  in  its  character  and  had  no  connexion  with  the  ordinary  instruc¬ 
tion  of  the  institution.  In  1828  the  number  of  students  amounted 
to  75,  and  in  1830  rose  to  185.  In  1834,  August  11th,  Doctor  Bur¬ 
den,  then  a  member  of  the  board  of  guardians,  offered  a  resolution 
to  appoint  a  committee  to  confer  with  the  Trustees  of  the  University 
and  Jefferson  Medical  College,  on  subjects  connected  with  the  in¬ 
terests  of  the  Alms  House.  The  scheme  which  the  Doctor  had  in 
contemplation,  was  in  the  first  place,  to  make  the  ticket  of  the  house 
essential  to  graduation,  and  in  the  second,  the  organization  of  a 
summer  school  of  practical  medicine  and  surgery  in  the  institution; 
neither  of  which  received  the  sanction  of  the  board.  The  first  was 
asking  a  discrimination  which  ought  not,  we  conceive,  ever  be  grant¬ 
ed  to  any  hospital,  the  second  was  a  wise  public-spirited,  practical 
suggestion,  which  ought  not  to  have  been  refused. 

It  was  this  year  the  Faculty  of  Jefferson  Medical  College,  then 
growing  into  deserved  importance,  requested  of  the  guardians  to  be 
placed  on  an  equal  status  with  the  University  in  regard  to  Clinical 
teaching.  The  plan  they  proposed  was  to  set  apart  two  wards  for 
them  in  the  hospital — one  for  medical  and  one  for  surgical  cases, 
and  alternate  weeks  for  their  Clinical  lectures.  Those  representing 
the  interests  of  the  University  objected  to  such  an  arrangement,  as 
calculated  to  mar  the  harmony  of  both  of  the  schools  and  the  hos¬ 
pital.  They  declare  having  undertaken  the  development  of  a  Clin¬ 
ical  school  at  a  time  when  scarcely  a  ticket  was  sold,  and  at  length 
succeeded  in  making  it  a  source  of  revenue  to  the  board,  and  a  for¬ 
midable  rival  of  the  Pennsylvania  Hospital — the  latter  not  selling 
over  30  tickets ;  and  last,  that  their  connexion  with  the  Clinic,  in  no 
way  prevented  the  students  of  another  College  enjoying  equal  advan¬ 
tages  with  their  own. 

This  year  (1834)  was  one  of  great  prosperity  to  the  Philadelphia 


26 


Hospital.  Two  hundred  Mid  twenty  students  were  in  attendance; 
the  proceeds  accruing  therefrom  amounting  to  fourteen  hundred  and 
twenty  dollars.  The  board  of  managers  appreciating  the  courtesies 
due,  to  .  ‘men  liberal  education  and  position  in  the  profession, 
with,  commendable  propriety  tendered  gratuitous  admission  to  all 
medical  men  attached  to  the  army  and  navy.  These  lectures  were 
delivered  on  Wednesday  of  every  week  during  the  winter  months. 
In  1835,  at  the  request  of  Doctors  Patterson  and  Calhoun,  the  day 
was  changed  to  Saturday,  in  accommodation  to  the  instruction  in  the 
Jefferson  College,  which  sent  this  year  79  students  to  the  clinic. 

The  transportation  was  no  inconsiderable  item.  Long  lines  of  om¬ 
nibuses,  (for  there  were  then  no  street  cars,)  were  stationed  about 
Ninth  and  Chesnut  streets,  on  Saturday  morning,  in  a  few  minutes 
crowds  of  students,  full  of  life  and  excitement,  were  stowed  away — 
not  seated — in  glorious,  good-natured  confusion  ;  and  at  the  usual 
salutation  of  the  knight  of  the  whip,  “  all  right,”  were  whirled  away 
at  a  spanking  speed,  some  to  the  South  street  ferry,  to  be  carried  over 
in  a  boat,  which  has  long  been  suspected  as  one  of  Charon’s — and 
in  so  far  as  the  transportation  of  spirits  was  concerned,  not  untruly; 
others  by  the  Market  street  bridge.  Some  of  my  most  pleasant  re¬ 
collections  of  college  life  in  1837,  are  associated  with  these  weekly 
trips,  so  admirably  calculated  to  relieve  the  tedium  of  the  town,  and 
regale  the  lungs  with  a  more  invigorating  air.  The  lecture  room 
was  situated  in  what  is  now  the  lunatic  department,  and  only  re¬ 
cently  abandoned.  It  was  the  most  capacious  and  finely  arranged 
amphitheatre  in  the  country,  and  capable  of  seating  from  seven  to 
eight  hundred  persons.  Until  1845,  this  hospital  continued  to  be 
the  great  clinic  school  of  the  country,  annually  opening  its  exhaust¬ 
less  treasures  of  disease  to  crowds  of  educated,  zealous  inquirers 
after  medical  knowledge.  The  unfortunate  events  which  in  1845 
succeeded  the  death  of  the  cockroach,  terminated  the  instructions 
for  several  years. 

CERTIFICATES  AND  TICKETS. 

In  1817  a  diploma,  or  certificate,  was  ordered  to  be  engraven,  the 
impressions  from  which  were  made,  some  on  paper  and  some  on  parch¬ 
ment,  designed  for  the  resident  pupils,  and  which  were  furnished  at 
three  and  four  dollars  a  copy.  In  September  1832  a  new  plate  was 
produced,  altogether  more  artistically  executed,  and  in  1835,  a  small 
vignette  view  of  the  house  was  ordered  to  be  engraven  and  printed 
on  the  tickets.  In  1860,  another  ligthographic  engraving  of  a  cer¬ 
tificate  was  executed.  The  design  represents  a  front  view  of  the  in- 


27 


stitution,  and  was  signed  by  the  President  of  the  board  of  Guardians, 
the  President  of  the  Medical  board,  and  the  Secretary. 

After  a  pause  of  several  years,  and  the  profession  becoming  more 
and  more  sensible  of  the  great  injustice  and  tyranny  perpetrated 
against  the  reputation  of  a  city  enjoying  such  unexampled  prosperi¬ 
ty  as  a  center  of  medical  education,  by  excluding  them  from  an  in¬ 
stitution  supported  largely  from  their  own  pockets,  and  possessed  of 
the  most  ample  resources  as  a  clinical  school,  began  to  move  in  the 
matter.  On  the  1st  of  May  1854,  the  Philadelphia  County  Medi¬ 
cal  Society  addressed  a  communication  to  the  Board  of  Guardians, 
asking  that  its  doors  be  opened  to  students  of  medicine.  The  docu¬ 
ment  was  forcibly  written,  but  produced  no  change  in  the  views  of 
that  body.  In  August  of  this  year,  Doctor  John  Beese,  register  of  the 
Medical  Faculty  of  Pennsylvania  College,  in  behalf  of  that  institution, 
communicated  with  the  board  on  the  same  subject,  and  guaranteed 
if  its  wards  were  opened  to  public  instruction,  the  sale  of  fifty  tickets 
from  that  school  alone.  These  appeals,  no  doubt,  had  some  weight 
with  the  guardians,  but,  to  Doctors  Henry  II.  Smith,  and  James  L. 
Ludlow,  (and  I  speak  from  personal  knowledge,)  more  than  to  all 
others  combined,  is  the  profession  of  Philadelphia,  and  the  country 
at  large,  indebted  for  the  re-establishment  of  a  Clinical  school,  with¬ 
in  the  walls  of  this  institution.  Neither  must  Doctor  Penrose  be 
overlooked  in  this  important  work,  as  he  labored  indefatigably  for 
the  same  end.  I  make  no  mention  of  my  own  efforts  in  the  same 
direction,  for  while  I  did  what  I  could,  I  was  comparatively  a  stranger 
in  the  city,  and  had  no  influence  whatever.  These  gentlemen  vis¬ 
ited  each  member  of  the  board  of  guardians  personally,  and  by  an 
unwearied,  persevering  presentation  of  the  subject  in  every  possible 
shape,  finally  succeeded  by  their  importunance,  as  the  widow  with 
the  unjust  judge,  in  revolutionizing  the  settled  sentiment  of  the 
board,  securing  a  favorable  report  from  the  hospital  committee,  and 
its  adoption  on  the  motion  of  Doctor  Henley,  by  the  general  board 
of  guardians.  The  rules  for  the  government  of  the  Clinic  were  re¬ 
ported  on  the  6th  of  September  1854,  and  provided  for  the  election 
of  two  physicians,  and  two  surgeons  in  addition  to  the  chief  resident 
officers. 

THE  ADMINISTRATION  BY  A  RESIDENT-IN-CHIEF;  AND  A  BOARD 
OF  LECTURERS  ON  CLINICAL  MEDICINE  AND  SURGERY. 

On  the  same  day  in  which  the  rules  were  reported,  (6th  of  Sep¬ 
tember  1854,)  the  guardians  proceeded  to  elect  the  medical  officers, 


28 


when  Doctors  J.  L.  Ludlow  and  Robert  Coleman  were  selected 
physicians,  and  Doctors  Henry  H.  Smith  and  D.  H.  Agnew,  sur¬ 
geons.  Doctor  Coleman  being  compelled  by  previous  arrangements 
to  resign,  Doctor  Casper  Morris  was  elected  in  his  place,  and  on  the  { 

30th  of  the  following  October,  the  staff  was  increased  by  the  appoint¬ 
ment  of  Doctor  R.  A.  F.  Penrose,  obstetrician  to  the  institution. 

Tickets  of  admission  were  fixed  at  ten  dollars,  including  transpor¬ 
tation,  two  days  in  the  week — Wednesday  and  Saturday — for  four 
months.  The  West  Chester  Rail  road,  which  passes  through  the 
grounds  of  this  institution,  was  just  being  completed,  and  an  arrange¬ 
ment  was  made  with  the  superintendent,  to  run  cars  from  Broad 
and  Market  streets  to  some  point  opposite  the  building,  on  the  days 
of  Clinical  lectures.  The  second  week  in  October  1854,  an  im¬ 
mense  train  left  Broad  street,  filled  to  repletion  with  medical  stu¬ 
dents,  to  witness  the  inauguration  of  this  important  event.  This 
passenger  train,  I  believe,  was  the  first  which  passed  over  the  long 
stretch  of  tressle  work  supporting  the  road  across  the  meadows  of 
this  property.  Its  living  freight  was  landed  opposite  the  river  point. 

Certainly  not  less  than  700  persons  were  present  in  the  old  amphi¬ 
theatre,  and  the  first  Clinic  of  the  new  era  was  held,  after  some  ap¬ 
propriate  remarks  by  Drs.  Smith  and  Ludlow.  On  the  following 
June  of  1855,  the  hospital  committee  deemed  it  proper  to  increase 
the  number  of  medical  ofiicers,  and  by  their  recommendation,  two  addi¬ 
tional,  were  added  to  each  staff.  These  were  Doctors  Joseph  Carson, 
and  J.  B.  Biddle,  to  the  medical,  Doctors  John  Neill,  and  R.  P. 

Thomas,  to  the  surgical,  and  Doctors  Wilson  Jewell,  and  Casper 
Morris,  to  the  obstetrical  departments,  the  latter  gentlemen  being 
transferred  from  the  medical  to  the  obstetrical  at  his  own  request. 

On  the  2nd  of  July  1855,  the  period  for  the  annual  election  of 
a  chief-medical  officer,  Doctor  Robert  K.  Smith  was  selected  by  the 
guardians,  and  who  co-operated  most  efficiently  with  the  Clinical  board, 
delivering  in  October  an  excellent  introductory,  and  participating  in 
the  clinical  instructions  communicated  to  the  class.  On  the  21st 
of  July,  1856,  Doctor  A.  B.  Campbell  was  elected  chief  resident 
physician.  A  remarkable  change  this  year  came  over  the  board  of 
guardians  in  reference  to  the  house  instruction.  It  is  altogether 
foreign  to  my  purpose  to  enter  into  any  analyses  of  the  instrumen¬ 
talities  employed  to  sway  the  opinions  of  these  gentlemen,  although 
they  were  quite  patent,  I  presume,  to  any  member  of  the  medical 
organization  connected  with  the  institution.  It  is  sufficient  to  say, 
that  on  the  motion  of  a  member,  offered  on  the  22nd  of  December 


29 


1856,  Clinical  instruction  in  the  Philadelphia  hospital  was  abolished 
after  the  termination  of  the  lectures  then  in  progress.  The  reason 
adduced  in  justification  of  this  act,  was  the  failure  of  the  Clinic  to 
meet  its  own  expenses.  The  record  stultified  the  allegation ;  and 
those  who  were  cognizant  of  the  facts,  could  not  but  feel  indignant 
at  so  audacious  a  falsification  of  the  case.  There  were  at  that  very 
time  seventy-five  students  in  attendance,  a  larger  number  than  usually 
attended  hospitals  either  in  this  country  or  Europe. 

On  the  8th  of  June  1857,  Doctor  Campbell  resigned,  and  was  sue’ 
ceeded  by  Doctor  James  M'Clintock,  very  shortly  after  which  event 
the  visiting  members  of  the  medical  organization  all  resigned,  several 
of  the  residents  physicians  withdrew  from  the  house,  and  again  the 
institution  ceased  to  administer  to  the  wants  of  the  medical  class 
of  Philadelphia. 

On  the  5th  of  July  1858,  Doctor  Robert  K.  Smith  again  became 
chief  resident  officer,  and  on  the  19th  of  the  same  month,  under  the 
auspices  of  this  new  medical  head,  Mr.  Reall,  a  member  of  the  board 
of  guardians,  proposed  to  re-establish  a  board  of  Clinical  lecturers. 
The  subject  for  a  time  was  laid  over,  until  the  11th  of  October,  when 
the  students  of  the  different  Medical  Colleges  in  the  city,  addressed 
a  communication  to  the  guardians,  praying  for  the  revival  of  medi¬ 
cal  instruction. 

On  the  22nd  of  November,  they  acceded  to  the  request ;  and 
proceeded  at  once  to  ballot  for  gentlemen  to  discharge  this  duty. 
Doctors  Joseph  Carson,  J.  B.  Biddle,  J.  Atkin  Meigs,  and  Samuel 
Dickson  were  elected  lecturers  on  Clinical  Medicine;  Doctors  John 
Neill,  W.  S.  Halsey,  Richard  J.  Levis,  and  D.  H.  Agnew,  on  Clin¬ 
ical  Surgery;  and  Doctors  R.  A.  F.  Penrose,  and  E.  McClellan,  on 
Obstetrics  and  diseases  of  Women  and  Children.  Doctor  Dickson's 
health  not  allowing  him  any  increase  in  his  labors,  was  compelled 
to  decline  serving,  and  in  his  place  Doctor  J.  Da  Costa  was  elected 
one  of  the  Physicians  ;  and  under  this  organization,  the  hospital 
commenced  again  to  discharge  one  of  its  legitimate  functions  to 
the  community.  On  the  4th  of  July,  1859,  the  old  board  of  guar¬ 
dians  was  abolished,  which  for  many  years  had  been  selected  by  a 
popular  vote,  and  a  new  one  consisting  of  twelve  members  appointed 
by  the  Courts  and  Councils,  came  into  power.  This  organization, 
consisting  of  the  most  respectable  and  intelligent  gentlemen  in  our 
community,  men  of  enlarged  liberal  views,  conjoined  with  superior 
practical  ability,  after  a  careful  survey  of  the  field,  entered  on  the 
work  of  reform.  Among  the  subjects  which  earliest  occupied  their 


30 


attention,  was  the  medical  department  of  this  institution.  The  re¬ 
sult  of  these  investigations  was  a  return  to  the  old  system,  dispen¬ 
sing  with  the  office  of  chief  resident,  and  placing  the  hospital  de¬ 
partment  under  the  charge  of  a  medical  board,  consisting  of  twelve  ( 

members,  to  act  as  physicians,  surgeons,  and  obstetricians,  and  who 
were  to  visit  the  institution  four  times  a  week.  The  election  for 
these  officers  took  place  on  the  8th  of  August,  1859,  at  which  Doc¬ 
tors  James  L.  Ludlow,  William  F.  Mayburry,  Charles  P.  Futt,  and 
Robert  Lucket,  were  selected  to  constitute  a  medical  staff;  Doctors 
S.  W.  Gross,  Richard  J.  Levis,  Robert  Kenderdine,  and  D.  II.  Ag- 
new,  a  Surgical  staff;  and  Doctors  R.  A.  F.  Penrose,  John  Wiltbank. 

William  D.  Stroud,  and  Lewis  Harlow,  an  obstetrical  staff.  It  was 
in  August,  of  this  year  the  professors  of  the  Homoeopathic  College, 
proposed,  in  a  communication  addressed  to  the  guardians,  to  take 
the  entire  charge  of  the  medical  department,  and  furnish  all  the 
medicines  for  the  sick,  without  any  charge  whatever.  On  the  27th 
December,  1859,  the  medical  board  underwent  some  changes,  in  con¬ 
sequence  of  questions  connected  with  the  political  state  of  the  coun¬ 
try,  and  which  have  since  inaugurated  a  revolution  of  unparralleled 
magnitude,  the  issue  of  which  on  the  destinies  of  race,  nation,  and 
the  world,  no  human  mind  can  foresee.  Doctor  Lucket,  espousing  the 
Southern  view  of  the  question,  induced  a  large  number  of  medical 
students,  to  abandon  the  Medical  Colleges  of  Philadelphia,  and  enter 
the  institutions  of  their  own  States.  The  Doctor  becoming  the  med¬ 
ical  Moses  of  this  exodus,  left  his  place  in  the  board,  to  which  Doctor 
J.  Da  Costa  was  elected  in  December  1859.  In  the  month  of  De¬ 
cember  1859,  Doctor  Wiltbank  resigned,  and  to  supply  the  vacancy, 

Doctor  George  Zeigler  was  elected.  Again,  in  May  7th,  1861, 

Doctor  Mayburry  was  compelled,  by  the  extent  of  his  professional 
duties,  to  withdraw  from  the  board,  and  to  which  place  Doctor 
0.  A.  Judson  was  elected. 

Since  the  new  organization  of  the  board  of  Guardians,  by  which 
in  a  great  measure  this  house  has  been  rescued  from  the  vortex  of 
politics,  its  medical  prosperity  and  popularity  have  been  steadily  in¬ 
creasing,  until  it  may  now  be  pronounced  the  great  Clinical  school 
of  this  country.  The  change  was  not  accomplished  without  a  strug¬ 
gle.  There  is  a  class  of  persons  who  can  only  subsist  in  the  seething 
cauldron  of  political  agitation,  and  who  cling  to  official  place  like 
barnacles  to  a  ship’s  bottom.  Of  such,  there  were  some  who  lost  no 
opportunity  to  prefer  charges  of  mismanagement  in  order  to  shake 
the  confidence  of  the  public  in  the  administration  of  the  present 


31 


organization.  On  the  25th  of  June,  1860,  it  was  stated  in  Com¬ 
mon  Council  that  a  great  increase  had  taken  place  in  the  mor¬ 
tality  of  the  institution  since  the  change  in  the  medical  system,  and 
a  committee  was  appointed  to  investigate  the  facts  of  the  case.*  In 
the  report  of  these  gentlemen,  it  will  be  seen  that  instead  of  the  mor" 
tality  being  increased,  it  had  been  greatly  diminished.  They  took 
the  last  year  of  the  old  board  of  guardians  which  expired  on  July 
the  1st,  1859,  and  contrasted  it  with  the  first  year  of  the  present  board? 
which  terminated  on  July  the  1st,  1860.  By  examination,  it  ap¬ 
peared  the  year  ending  July,  1859,  the  average  population  of  the 
house  was  2513,  and  the  deaths  for  the  same  period  were  657,  or 
26.15  per  cent,  of  the  average  population.  For  the  year  ending 
July  1st,  1860,  the  average  population  was  2520,  and  the  deaths  for 
the  same  time  were  589  or  23.30  per  cent,  of  the  average  population. 
This  showed  a  decrease  of  68  in  the  number  of  deaths,  or  11  per 
cent,  on  the  mortality  of  the  previous  year.  In  the  Insane  Depart¬ 
ment  for  the  same  years — that  is  1859,  with  an  average  population 
of  400,  there  were  96  deaths  or  24  per  cent,  on  the  above  average. 
In  1860  the  average  population  was  425,  and  72  deaths — or  not 
quite  17  per  cent,  of  the  average  population,  a  decrease  of  38  per 
cent,  on  the  mortality  of  the  previous  year.  They  go  on  further  to 
state,  that  it  must  be  remembered  only  a  part  of  the  population  of 
the  Alms  House  is  under  medical  treatment,  and  that  the  proper 
basis  to  determine  the  per-centage  of  mortality  among  the  inmates, 
should  be  taken  from  the  Hospital.  For  this  purpose,  the  Commit¬ 
tee  took  the  last  published  report  of  the  late  Chief  Resident  of  the 
former  board,  for  1858.  Its  author  declares,  during  that  period  the 
institution  shows  a  smaller  mortality  than  had  been  known  for  many 
years.  By  that  report,  in  the  various  wards  of  the  Hospital,  Chil¬ 
dren’s  Asylum  and  Nursery,  there  were  treated  5335  cases  of  disease, 
of  which  number  549  died,  or  10-29  per-cent.  The  books  of  the 
present  board  showed  6176  cases  treated,  and  478  deaths,  or  7-74 
per  cent ,  exhibiting  a  decrease  of  25  per  cent,  on  the  mortality  of 
the  former  year.  This,  then,  was  a  vindication  of  the  wisdom  of  the 
guardians,  in  establishing  the  present  medical  organization,  and 
rested  on  a  mathematical  demonstration  which  even  its  enemies 
dare  not  gainsay.  On  the  10th  of  September  1860,  the  medical 
board  addressed  the  guardians  on  the  propriety  of  throwing  open 
the  wards  of  this  hospital  for  free  clinical  instruction.  This  propo- 

*  Journal  of  Common  Council,  from  May  to  November,  1806,  Page  121. 


32 


sition  was  considered  from  a  liberal  and  intelligent  stand  point,  in 
its  broader  and  more  general  bearings,  and,  on  the  24th  September, 
1860,  received  their  cordial  sanction;  and  to  this  time,  and  it  is  to 
be  hoped,  through  all  time  to  come,  its  doors  may  never  be  closed 
against,  or  a  fee  craved  from,  those  who  enter  its  halls  in  search  of 
that  knowledge  which  can  alone  render  them  qualified  to  discharge 
the  functions  of  a  divine  art. 

In  the  month  of  April  1861,  the  guardians  furnished  another 
proof  of  the  confidence  which  they  reposed  in  the  medical  board, 
by  authorizing  the  construction  of  the  present  lecture  room,  which 
for  elegance  and  convenience  has  no  superior;  and  which  was  form¬ 
ally  inaugurated  on  the  16th  of  October  1861,  in  an  able  address 
from  Dr.  James  L.  Ludlow,  on  the  subject  of  the  Rise  and  Progress 
of  Clinical  Instruction. 


MUSEUM. 

On  the  25th  of  November,  1814,  the  first  effort  was  made  to 
establish  a  Hospital  Museum.  The  Board  required  every  resident 
pupil  to  leave  in  the  house  a  preparation  made  by  himself.  That 
the  rule  was  enforced  for  a  time  there  can  be  no  doubt,  for  on  the 
26th  of  February,  1822,  1  find  the  acknowledgment  of  the  following 
anatomical  preparations : — A  Corroded  Kidney,  by  J.  T.  Sharpless ; 
A  Side  View  of  the  Head,  with  the  Vessels  Injected,  by  J.  M. 
Fox ;  A  Specimen  showing  the  Anatomy  of  Scrotal  Hernia,  by  Ed¬ 
ward  L.  Dubarry,  and  a  Foetal  preparation,  showing  the  vessels 
peculiar  to  the  circulation.  Where  are  these  now  ?  The  23d  of 
November  1840,  Doctor  Burden,  one  of  the  guardians,  presented  a 
resolution  to  fit  up  a  room  in  the  centre  building  of  the  hospital  for 
a  museum,  which  was  to  be  placed  under  the  charge  of  the  apothe¬ 
cary,  to  whom  all  the  morbid  specimens  were  to  be  given  for  pre¬ 
servation.  The  first  museum  contemplated,  was  evidently  to  be  only 
a  depository  for  normal  anatomical  specimens :  this  last  may  be 
considered  as  the  inception  of  a  pathological  cabinet.  There  were 
three  things  which,  of  course,  rendered  it  impracticable.  First, 
the  curator  was  to  be  the  apothecary,  who,  of  course,  knew  nothing 
of  pathology ;  second,  there  were  no  provisions  made  for  dissecting 
the  specimens;  and  last,  at  this  very  period,  the  subject  of  post 
mortems  was  embarrassed  by  more  formalism  than  would  be  neces¬ 
sary  to  ratify  and  induct  an  Archbishop  into  his  holy  calling. 

On  the  10th  of  September  1860,  the  present  board  of  guardians, 
acting  on  the  recommendation  of  the  medical  board,  authorized  the 


33 


founding  of  a  pathological  museum,  to  which  the  writer  was  assigned 
as  Curator.  For  the  perpetuation  of  this  important  undertaking, 
an  annual  appropriation  of  two  hundred  dollars  is  made,  and  which, 
if  judiciously  expended,  will  serve  to  preserve  a  large  amount  of 
pathological  material.  The  work  has  begun.  Already  a  considerable 
collection  has  been  placed  on  the  shelves  of  this  museum;  some  of 
them  quite  unique  of  their  kind,  and  all  most  valuable  illustrations 
of  morbid  structure.  Although  much  of  this  work  has  been  done 
at  considerable  personal  inconvenience,  yet  I  assure  you  it  is  with 
no  ordinary  feelings  of  pride  and  pleasure,  that  I  regard  the  associa¬ 
tion  of  my  name  with  an  enterprise,  which  if  prosecuted  with  ordi¬ 
nary  industry  and  intelligence,  will  in  a  few  years  secure  to  the 
Philadelphia  Hospital  the  most  valuable  collection  of  morbid 
anatomy  to  be  found  anywhere  in  this  country. 

LIBRARY. 

Among  the  wants  specified  by  the  board  in  1805,  when  they  went 
before  the  Legislature  for  aid,  was  a  room  to  be  appropriated  for  a  libra¬ 
ry.  About  the  beginning  of  the  year  1808,  this  work  commenced, 
and  on  the  9th  of  May,  one  hundred  and  fifty  dollars  were  appropriated 
by  the  managers  for  the  purchase  of  books,  to  be  selected  by  the 
physicians  of  the  institution.  Rules  were  reported  shortly  after  for 
its  management,  and  the  senior  resident  student  appointed  librarian, 
at  which  time  the  books  were  labelled  and  numbered.  In  1810 
another  appropriation  of  one  hundred  and  fifty  dollars  was  made  for 
the  same  purpose.  On  the  28th  of  December  1812,  a  committee 
was  appointed  to  draft  rules  for  the  management  of  the  library,  and  at 
this  date  there  was  an  unexpended  balance  to  its  credit  of  four  hundred 
dollars,  which  was  money  received  from  the  house  pupils.  In  1813 
a  rule  was  passed  conferring  a  life  privilege  to  the  use  of  the  library, 
for  the  sum  of  thirty  dollars.  This  year  three  hundred  dollars  was  ex¬ 
pended  in  books,  duplicates  of  all  elementary  works  being  ordered. 
In  1815  free  access  was  allowed  to  physicians  and  students  who  should 
attend  the  practice  of  the  house  for  two  years,  and  also  to  private 
pupils  of  the  medical  officers  of  the  institution.  In  1816,  the  apothe. 
cary  was  appointed  librarian,  and  the  library  catalogued.  On  the 
18th  of  August  1818,  by  a  report  of  Doctor  M’Clellan,  the  library 
contained  1022  volumes,  and  597  different  works.  On  the  8th  of 
November  1824,  the  managers  passed  a  resolution  making  an  annual 
appropriation  of  two  hundred  dollars  for  the  benefit  of  the  library.  In 
1827,  Doctor  Horner  presented  the  institution  with  one  hundred  and 


34 


twenty  theses  from  Edenburg.  In  1831  it  was  again  catalogued  by 
Doctor  Rivanus,  one  of  the  resident  physicians,  and  contained  some 
very  valuable  works.  In  November  1836,  Doctor  Charles  Pickering 
applied  to  the  board  for  certain  works  in  their  possession,  for  the 
use  of  the  United  States  Exploring  Expedition,  and  which  were  not 
attainable  in  this  country ;  offering  a  large  advance  on  the  importa¬ 
tion  price  as  an  inducement  to  sell.  The  matter  was  referred  to  the 
medical  board  and  refused.  Accessions  were  made  from  time  to 
time,  by  appropriations  made  out  of  the  proceeds  resulting  from  the 
sale  of  clinical  tickets,  until  it  numbered  over  3000  volumes;  the 
finest  collection  of  ancient  medicine  and  surgery,  probably  any 
where  to  be  found.  For  the  last  fourteen  years  very  little  attention  has 
been  bestowed  on  this  important  appendage  to  a  great  hospital.  On 
the  contrary,  it  has  been  plundered  by  the  vandalism  to  which  it  has 
been  exposed,  of  much  valuable  matter.  At  present,  however,  it  has 
been  placed  under  the  care  of  Doctor  Tutt,  and  having  been  re¬ 
moved  from  the  lunatic  department,  is  being  re-arranged  in  a  very 
excellent  room  appropriated  to  its  use,  in  the  north  end  of  the  hos¬ 
pital  building.  An  appropriation  is  now  annually  made  by  the 
present  board  of  guardians  for  its  improvement  and  preservation 
and  we  may  hope  to  see  it  again  growing  in  value  every  year. 

INSANE  DEPARTMENT. 

The  Alms  House  buildings,  as  first  constructed,  were  not  adapted 
to  the  reception  of  insane  patients,  especially  if  laboring  under  a 
violent  type  of  mental  disease.  The  managers,  therefore,  were  in 
the  habit  of  placing  such  cases  in  the  Pennsylvania  hospital,  whose 
arrangements  were  much  safer  and  better  for  the  control,  of  lunatics. 
The  expense  of  supporting  them  in  this  institution  was  an  item  of 
much  complaint  on  the  part  of  the  managers  of  the  Alms  House,  and 
on  July  the  4th,  1803,  the  physicians  had  a  meeting  on  this  subject 
They  recommended,  in  order  to  accommodate  the  insane  poor,  to  con. 
vert  as  much  of  the  new  range  of  buildings  (at  11th  and  Spruce 
streets)  as  could  be  spared,  into  cells  for  their  accommodation.  The 
board  not  thinking  this  locality  altogether  safe,  fitted  up  the  cellar 
under  the  west  wing  of  the  house,  then  occupied  as  a  dining-room. 
This  improvement  was  completed  in  December  1803,  and  thither  to 
this  subterranean  prison,  were  ten  persons  removed  from  the  Penn¬ 
sylvania  hospital — the  number  of  the  violent  class  then  under  the 
care  of  the  managers.  The  names  of  these  first  ten  occupants  were 
John  Savage,  Robert  Crawford,  George  W.  Odenheimer,  John 


35 


McClean,  Stephen  West,  Mary  McFall,  Catharine  Erringer,  Chris- 
tianna  Griskey,  Sarah  Tomb,  and  Abbe  Conly. 

The  portion  thus  set  apart  in  a  few  years  became  insufficient,  some 
of  the  cells  containing  two  maniacs.  The  medical  officers  again 
pressed  the  necessity  of  additional  buildings,  as  a  measure  enforced 
by  every  consideration  of  humanity.  These  underground  cells  were 
damp,  chilly  caverns,  with  insufficient  light,  and  imperfect  ventilla- 
tion  :  they  were  close  to  the  sick  and  surgical  wards,  and  the  noise 
of  these  creatures,  bereft  of  reason,  howling  like  caged  beasts,  ex¬ 
erted  not  only  an  unpleasant  influence  on  the  sick,  but  even  shocked 
the  public  ear.  In  1833  the  insane  were  removed,  in  common  with 
the  other  poor,  to  the  present  building,  a  part  of  which  had  been 
constructed  for  this  unfortunate  class;  that  is  furnished  with  those 
mechanical  contrivances  which  were  deemed  essential  to  their  treat¬ 
ment.  Among  the  results  of  scientific  medicine,  there  are  none, 
gentlemen,  which  have  been  fraught  with  so  much  of  blessing,  as 
those  which  have  crowned  the  rational  study  of  mental  disease. 
The  damp  and  gloomy  cells  of  the  old  Alms  House  on  Spruce  street, 
and  the  walls  and  subterranean  vaults  of  the  present,  furnished 
familiar  demonstrations  of  the  frightful  armamentarium  at  their  com. 
mand,  not  indeed  for  restoring  reason,  but  to  scare  her  forever  from 
her  seat  in  the  soul.  You  have  but  to  cross  the  area  of  this  enclosed 
square,  to  see  still  the  iron  hooks  in  the  floor  where  they  were  tied 
down  hands  and  feet,  the  rings  in  an  outer  wall  to  which  they  were 
chained  like  wild  animals,  when  led  from  their  gloomy  abode  to  enjoy 
for  a  little  the  pure  air  and  sunlight  of  heaven.  There,  too,  may 
be  still  seen  the  traces  of  blood,  and  the  marks  of  the  teeth,  as  they, 
have  in  their  agony,  vainly  endeavored  to  gnaw  through  the  door& 
which  restrained  their  liberty,  and,  not  the  least  horrible  of  these 
inquisitorial  mechanism,  there  still  stands  the  Composing  chair  in 
which  the  doomed  lunatic  was  secured,  his  head  supporting  a  capa¬ 
cious  box  filled  with  ice,  which  melting,  poured  its  chilling  streams 
adown  his  person  for  hours  together.  In  1835  the  hospital  com¬ 
mittee  authorized  the  purchase  of  books,  prints,  and  musical  instru¬ 
ments  for  the  use  of  the  lunatic  department,  and  more  than  usual 
interest  for  a  time  was  manifested  in  improving  their  condition.  In 
the  beginning  of  1845  a  ball  was  given  for  their  amusement,  and  with 
such  satisfactory  results  that  Doctor  Dunglison  in  the  following  April 
asked  its  repetition. 

On  the  17th  of  September  1849,  Doctor  Henley  was  appointed 
assistant  physician  to  this  department  and  to  the  small-pox  hospital, 


36 


at  a  salary  of  $500.  In  this  position  he  continued  until  Feb¬ 
ruary  1852,  when  he  resigned,  and  was  succeeded  by  Doctor - 

Benton.  Shortly  after,  however,  Doctor  Benton  was  superseded  by 
the  re-appointment  of  Doctor  Henley  to  his  old  post,  with  a  salary  ^ 

increased  to  seven  hundred  dollars.  This  office  was  abolished,  I 
think  in  1854,  and  from  that  time  forward  the  Asylum,  until  a  recent 
period,  was  lapsing  rapidly  into  disorder  and  decay.  Among  the 
noblest  acts  of  the  present  board  of  guardians,  was  the  reorganiza¬ 
tion  of  this  department.  None  but  those  who  were  conversant  with 
the  house,  can  form  any  conception  of  its  utter  inefficiency  to  ful¬ 
fill  the  purposes  contemplated  by  such  an  institution.  It  was  visited 
for  the  most  part  by  sightseers ,  attracted  by  the  same  motives  as 
one  who  visits  an  exhibition  of  animals.  The  hallucinations  and 
eccentricities  of  these  poor  God-smitten  creatures  were  the  subject  of 
thoughtless  sport,  and  became  strengthened  and  confirmed,  by  being 
maintained  in  a  state  of  constant  activity.  It  was  a  burning 
shame  on  the  good  name  of  this  Christian  community ;  that  such 
a  cage  of  idleness,  uncleanness,  and  disorder,  should  have  been 
tolerated  for  a  moment  in  their  midst.  On  the  24th  of  September 
1859,  the  insane  were  separated  from  the  hospital  department,  and 
placed  under  the  charge  of  a  chief  medical  officer,  Doctor  S.  W. 

Butler,  at  a  salary  of  one  thousand  dollars  per  annum.  Since  this 
event,  a  new  state  of  things  has  been  introduced.  An  air  of  order, 
comfort,  and  cheerfulness  is  noticeable  on  every  side;  industry  has 
taken  the  place  of  idleness;  and  there  may  be  seen  numbers  of  the 
inmates  busily  engaged,  some  cultivating  with  judgment  and  evident 
gratification,  a  garden  of  vegetables;  some  in  sewing  and  making  up 
garments  of  various  kinds;  some  working  at  shoes,  and  some  enliven¬ 
ing  the  ear  with  the  delightful  sounds  of  music,  executed  with  no 
ordinary  degree  of  taste  and  skill.  By  the  last  year’s  report  it  will 
be  seen  that  nearly  all  the  vegetables  used  by  the  house  have  been 
cultivated  by  the  insane,  amounting  in  money  value  to  $958  63. 

They  will  soon,  it  is  further  stated,  make  all  the  clothing  and  shoes 

consumed  by  the  department.  Another  ameliorating  and  salutary 

feature  is  the  revival  by  Doctor  Butler  of  the  musical  entertainments 

when  the  inmates,  at  the  sound  of  the  violin  aud  piano,  select  their 

partners,  and  with  all  the  decorum  and  conventional  proprieties  of  A 

rational  society,  thread  the  giddy  mazes  of  the  dance,  exhibiting  the 

most  striking  expressions  of  mirth  and  enjoyment.  Such  a  regimen 

is  well  calculated  to  introduce  new  trains  of  thought,  which  serve 

either  to  substitute  those  which  constitute  the  phenomena  of 


37 


their  insanity,  or  enable  the  individuals  to  correct,  by  a  legitimate 
induction,  the  delusions  under  which  they  may  labor. 

I  am  indebted  to  Doctor  Butler  for  tables  which  furnish  the  fol¬ 
lowing  results.  From  1834  to  1861  (inclusive)  there  have  been  re¬ 
ceived  into  the  men’s  department,  3858  insane  persons,  whose  social 
state  was  as  follows :  1803  single,  1054  married,  332  widowed,  and 
669  unknown.  Of  the  habits  of  the  number,  the  following  may  be 
stated :  449  were  temperate,  371  moderate,  528  intemperate,  leaving 
2510  unknown.  In  the  women’s  department,  from  18o5  to  1861 
(inclusive)  there  have  been  received  3473 — the  social  state  and  hab¬ 
its  of  which,  however,  are  not  compiled  later  than  1845,  and  which 
are  as  follows:  329  single,  299  married,  and  222  unknown;  214 
temperate,  14  moderate,  67  intemperate,  and  635  unknown,  in  a 
total  of  928. 


APOTHECARIES  AND  HOUSE  PUPILS. 

Until  June  the  6th,  1788,  there  is  no  evidence  that  the  medi¬ 
cines  requisite  for  the  sick  were  prepared  in  the  house,  or  that  per¬ 
sons  instructed  in  medicine  resided  in  the  institution.  The  apothe¬ 
cary  shop  was  established  at  the  date  just  stated,  and  John  Trust, 
being  recommended  by  the  physicians,  was  appointed  to  that  office. 
The  duties  were  both  pharmaceutical  and  medical,  and  this  officer 
was  required  to  be  either  a  graduate  or  an  advanced  student.  Under 
the  first  he  was  to  prepare  and  dispense  the  prescriptions  of  the 
attending  physicians ;  and  under  the  second,  he  was  to  attend  to 
the  ward  dressings,  keep  a  record  of  the  name,  date  of  admission, 
sex,  age,  disease,  event  of  each  inmate,  and  preserve  an  account  of 
the  number  of  women  delivered  in  the  obstetrical  ward.  The  re¬ 
muneration  was  board,  washing  and  lodging.  In  1789  an  addi¬ 
tional  one  was  deemed  necessary,  and  we  find  the  name  of  John 
Davidson  mentioned  as  apothecary  and  house  pupil.  In  1802  the 
number  was  increased  to  three;  and  the  system  of  juniors  and  seniors 
first  introduced. 

The  eldest  was  styled  the  senior  student,  the  next  the  junior  stu¬ 
dent,  and  the  third  called  the  apothecary  to  the  infirmary.  The 
senior  was  to  attend  the  sick,  keep  a  history  of  all  cases  which  the 
medical  attendant  might  direct,  with  a  register  of  the  name,  date  of 
admission,  age,  sex,  disease  and  event.  The  junior  was  to  dress, 
cup,  bleed  in  the  surgical  wards,  visit  the  working  wards  daily,  and 
if  any  were  sick,  report  the  same  to  the  senior,  and  keep  in  order 
the  surgical  instruments  and  apparatus  belonging  to  the  house.  The 


38 


apothecary,  besides  preparing  the  prescriptions,  was  required  to  cup 
and  bleed  in  tbe  medical  ward.  Each  of  these  house  pupils  was 
to  pay  eighty  dollars,  and  serve,  the  senior  two  and  a  half,  and  the 
others,  three  and  a  half  years. 

In  1811  the  number  of  house  pupils  or  apprentices,  as  they  were 
occasionally  termed,  was  increased  to  four  during  the  winter,  and 
three  the  summer  season,  each, to  pay  one  hundred  dollars  into  the 
treasury,  for  the  benefit  of  the  house.  In  1818,  the  number  was 
fixed  at  four  for  the  entire  year;  two  seniors  and  two  juniors.  All 
candidates,  to  be  eligible  for  an  election,  must  have  been  under  the 
instruction  of  some  practitioner  for  two  years,  attended  one  course 
of  medical  lectures,  pay  before  entering  on  service  one  hundred  dol¬ 
lars  into  the  hands  of  the  Treasurer,  and  give  bonded  security  for 
the  faithful  performance  of  his  duties.  The  seniors  rotated  monthly 
in  the  different  departments  of  the  hospital,  the  juniors  every  two 
months.  The  obstetrical  cases  were  attended  alternately  by  both 
juniors  and  seniors.  The  juniors  prepared  all  prescriptions,  kept  a 
careful  record  of  the  same,  and  were  present  with  the  seniors  during 
their  stated  rounds  with  the  sick.  In  1816  the  house  pupils’  fee 
was  increased  to  one  hundred  and  fifty  dollars,  and  the  term  of  ser¬ 
vice  reduced  to  six  and  twelve  months.  This  year,  at  the  sugges¬ 
tion  of  the  visiting  physicians,  the  managers,  believing  there  were 
ample  duties  to  employ  one  person  constantly  in  the  apothecary 
shop,  disconnected  the  office  of  apothecary  to  the  infirmary  from 
that  of  house  pupil,  and  established  it  as  a  distinct  position,  with  a 
salary  of  three  hundred  dollars  a  year.  After  a  single  years’  trial 
the  office  was  abolished,  but  so  injudiciously,  that  on  the  2nd  of 
February  1818,  they  were  compelled  to  re-establish  it  again.  Gerard 
S.  Marks  was  appointed  to  this  office,  which  situation  he  continued 
to  occupy  until  his  death  in  1832.  He  was  succeeded  by  his  son, 

Samuel  P.  Marks,  and  next  by  James  N.  Marks,  first  as  assistant, 
and  afterwards  as  principal,  which  position  he  continued  to  fill  with 
unexampled  ability  until  March  the  8th,  1852 — seventeen  years. 

Mr.  James  N.  Marks  was  for  many  years  a  member  of  the  board  of 
guardians,  a  man  of  practical  ability,  and  whose  record,  I  have  no 
doubt,  stands  unimpeached.  After  the  resignation  of  Mr.  Marks, 

the  board  elected  Mr.  - Huffnell  apothecary,  in  which  capa-  ^ 

city  he  continued  to  act  until  1856,  when  Mr. - Bender,  who 

had  been  acting  as  assistant,  became  now  the  principal.  In  1817 
the  population  of  the  hospital  had  so  increased  that  it  was  found 
necessary  to  provide  a  larger  number  of  resident  pupils,  and  to  meet 


39 


the  wants  thus  arising,  eight  were  elected,  to  serve  for  six  and  twelve 
months.  In  1820  the  title  by  which  these  gentlemen  were  called 
was  changed  from  house  pupil,  to  that  of  house  surgeons,  and  house 
physicians.  The  following  year,  1821,  the  resident  fee  was  increased 
to  two  hundred  dollars.  In  November  1822,  the  managers  believing 
fewer  residents  could  meet  all  the  demands  of  the  institution,  reduced 
the  number  to  six,  and  the  next  year,  1823,  in  consequence  of  a 
civil  strife  between  some  of  the  managers  and  the  house  physicians, 
the  medical  board  advised  a  change  in  the  mode  of  attending  the 
sick,  by  dispensing  altogether  with  resident  under-graduates,  and 
electing  two  graduates  in  medicine,  of  known  ability,  and  who  were 
to  receive,  instead  of  a  salary,  an  honorarium,  in  the  form  of  a 
piece  of  plate,  with  a  proper  inscription,  and  not  to  exceed  one  hun¬ 
dred  dollars  in  value.  The  plan  proposed  was  adopted,  without  the 
contemplated  plate,  but  could  not  have  met  the  expectations  of  the 
board,  as  the  resolution  was  rescinded  the  same  year,  and  resort  had 
to  the  old  plan.  On  the  8th  of  November  1824,  the  Medical  board 
recommended  the  examination  of  all  candidates  for  the  medical  ser¬ 
vice  of  the  hospital,  that  they  might  be  able  to  secure  the  best 
qualified  talent,  and  which  received  the  sanction  of  the  managers. 
Another  suggestion  of  the  medical  board,  which  was  endorsed  by 
the  same  gentlemen,  was  the  election  of  two  additional  pupils,  to  be 
called  Recorders,  whose  duty  was  to  keep  an  accurate  history  of  all 
cases  of  disease  in  the  institution,  a  work  which,  had  it  been  carried 
out  in  good  faith  to  this  day,  would  have  constituted  a  treasure  of 
medical  knowledge  unequalled  in  value  by  any  country.  Nothing 
practical  or  important,  however,  emanated  from  this  office.  Here 
and  there,  among  musty  and  defaced  papers,  I  discovered  a  few 
histories,  as  one  searching  among  ancient  ruins  meets  with 
broken  pillars,  and  fragments  of  dismembered  arches.  They  never 
can  be  gathered  together  from  amidst  the  dust  of  time  and 
decay,  and  framed  into  a  symmetrical  piece.  In  1828  the  seniors, 
by  a  resolution  of  the  Board  of  Guardians,  were  styled  Resident 
Physicians,  and  the  juniors,  Resident  Students.  In  1835  the 
fee  exacted  from  those  elected  to  either  position  was  two 
hundred  and  fifty  dollars,  and  which  seems  to  have  so  remained 
until  September  1839,  when  it  was  reduced  to  fifty  dollars  and 
the  price  of  board.  From  that  period  to  the  present  the  number 
of  resident  physicians  has  been  eight,  boarded  and  lodged  at  the 
expense  of  the  institution,  and  required  to  deposit  one  hundred 
dollars  as  a  collateral  assurance  for  the  fulfillment  of  their  contract, 


40 


and  to  be  returned  at  the  expiration  of  their  term  of  service, 

or  when  honorably  discharged.  There  have  been  since  1788, 

the  year  in  which  it  may  be  said  the  system  of  residentship  was 

established,  three  hundred  and  fifty  pupils,  or  physicians  officiating  ^ 

in  this  capacity ;  and  among  whom  will  be  found  those  of  the  most 

distinguished  physicians  and  surgeons,  dead  and  living,  North  and 

South,  for  the  last  quarter  of  a  century.  Here  is  one  of  those 

examples  of  moral  re-action  or  compensation,  as  noticeable  among 

the  groups  incident  to  the  social  state,  as  between  the  kingdoms  of 

nature  elsewhere.  Poverty,  misfortune,  and  sickness,  universally 

regarded  as  evils,  yet  counterbalanced  by  yielding  as  fields  for 

scientific  observations,  a  rich  harvest  of  solid,  practical  medical 

knowledge. 

EPIDEMICS. 

In  an  institution  giving  shelter  to  the  destitute,  decrepid  and 
broken-down;  the  existence  of  epidemic  and  malignant  disease  may 
very  naturally  be  anticipated;  and  this  house  has  proved  no  excep¬ 
tion  to  the  rule.  In  the  early  period  of  its  existence,  very  little 
satisfactory  information  can  be  gathered  in  regard  to  the  details  of 
its  prevailing  maladies.  During  the  Spring  months  of  1776  the 
inmates  suffered  very  severely  from  both  small-pox  and  putrid  sore 
throat.  Many  cases  of  the  worst  character  were  taken  from  the 
house,  and  quartered  in  private  lodgings,  with  the  hope  of  staying 
their  fatal  progress.  No  mention  is  made,  either  of  the  number  of 
cases  attacked,  or  the  deaths,  and  therefore  the  extent  of  the  mortality 
can  only  be  approximately  arrived  at.  The  cost  of  burials,  with  a 
population  of  two  hundred,  and  in  the  ordinary  health  of  the  insti¬ 
tution,  was  about  £18.  The  year  under  consideration — 1776 — the 
expense  of  burying  amounted  to  £47,  sufficient  to  show  the  mor¬ 
tality  had  been  doubled. 

In  1779,  a  form  of  intermittent  fever  prevailed  during  the  month 
of  April,  concerning  which  it  is  said,  “  there  were  deaths  daily,  and 
much  distress  in  the  house.”  For  nine  years  following  1779,  the 
institution  appears  to  have  enjoyed  a  wonderful  exemption  from 
fatal  diseases,  or  until  1788,  when  a  person  in  the  month  of  Feb¬ 
ruary  was  admitted  from  Southwark,  indisposed  from  some  unde-  ( 

veloped  affection.  Shortly  after,  his  disease  proved  to  be  small-pox, 
which  spread  with  great  rapidity  among  the  inmates.  This  was 
among  the  most  terrible  scourges,  as  vaccination  had  not  been  dis¬ 
covered,  and  against  inoculation  there  was  a  wide-spread  prejudice. 


41 


In  1793  Philadelphia  was  visited  by  the  yellow  fever,  and  this 
institution  was  doomed  to  pass  through  the  severest  ordeal  which  it 
had  ever  sustained.  It  is  quite  impossible  for  us  at  this  day  to  form 
any  just  conception  of  the  panic  which  seized  the  public  mind  on 
the  appearance  of  this  desolating  plague.  There  is  something  very 
extraordinary  and  appaling  in  the  moral  effects  of  those  unseen 
agencies  with  which  God  sometimes  scourges  a  city  or  nation.  Men 
can  preserve  their  courage  and  composure  on  the  field  of  battle, 
where  the  mailed-clad  hosts  of  contending  armies  struggle  for  vic¬ 
tory  amid  the  roar  of  artillery  and  the  shouts  of  their  captains,  but 
let  the  Angel  of  pestilence,  that  walketh  in  darkness,  or  wasteth  at 
noonday,  shake  from  his  sable  wings  the  invisible  spores  of  infection 
and  death,  and  the  merchant  sinks  at  his  desk  ;  or  the  artisan  totter 
and  fall  at  his  bench;  or  an  acquaintance  making  a  transient  call  on 
a  friend,  suddenly  grow  pale  and  feeble,  is  borne  home  to  his  bed, 
to  struggle  a  little,  gasp  and  die :  I  say,  let  men  witness  a  few  such 
scenes  as  these,  and  they  soon  betray  the  veriest  cowardice  and  fear. 

During  the  prevalance  of  the  fever,  the  whole  face  of  the  city  was 
changed.  There  was  then  no  funeral  trains  attended  with  the  usual 
pomp  and  pageantry  of  mourning;  no  coffins  of  elaborate  workman¬ 
ship,  to  contain  the  mortal  remains  of  the  dead,  and  borne  with 
formal  steps  to  their  last  resting-place.  On  every  hand  the  beholder 
encountered  open  and  unattended  carts,  containing  rude  boxes, 
exposed  to  the  public  gaze,  and  hurried  with  all  despatch  to  be  buried 
out  of  sight — not  in  single  graves — but  numbers  together  in  capacious 
pits.  Men  cared  not  to  tarry  on  the  street,  but  hastened  on  with 
furtive  glance,  as  though  the  fell  destroyer  followed  on  their  track. 
There  were  no  hearty,  joyous  salutations.  Men  exchanged  the  com¬ 
mon  civilities  of  recognition  as  though  never  expecting  to  meet 
again.  The  ties  even  of  kindred  blood  lost  their  wonted  power ; 
families  became  a  terror  to  one  another,  fleeing  asunder,  as  one 
would  hasten  from  devouring  flame.  The  song  of  the  drunkard  had 
ceased;  the  saloons  of  dissipation  were  closed;  the  haunts  of  vice 
were  unfrequented ;  and  even  the  shameless  votaries  of  lust  and  lewd¬ 
ness,  slunk  into  their  dens  of  infamy.  As  a  means  of  protecting 
the  inmates,  the  medical  attendants  reccommended  the  board  to  grant 
no  admissions  whatever.  Still  the  precaution  proved  unavailing; 
the  disease  broke  out  in  the  house,  and  large  numbers  were  attacked. 
Very  many  were  removed  to  the  hospital  on  Bush  Hill.  There  are  no 
records  or  other  sources  of  information,  from  which  any  statistical 
light  can  be  drawn,  either  to  determine  the  number  of  cases,  or 


42 


the  mortality.  That  it  was  great,  there  is  little  room  to  doubt. 
When  the  disease  was  at  its  height,  most  of  the  managers,  infected 
with  the  common  panic  and  wide-spread  distress,  did  not  venture  to 
attend  the  institution.  But  there  were  the  medical  attendants,  and 
the  steward,  who  never  deserted  their  posts,  but  stood  by  this  flock 
of  decrepid,  friendless  poor,  with  a  devotion  and  moral  heroism, 
which,  I  rejoice  to  say,  has  ever  been  the  glory  of  our  profession. 
During  the  prevalence  of  the  epidemic,  the  demand  for  graves  was 
so  great,  that  the  poor  were  unable  to  dig  them  with  proper  care. 
Potter’s  field,  now  the  beautiful  Washington  Square,  was  the  public 
burying-ground.  The  interments  were  so  numerous  and  incomplete, 
as  to  call  forth  a  remonstrance  against  depositing  any  more  bodies 
within  the  inclosure.  In  1801,  there  was  a  pauper,  Thos.  Wilkin¬ 
son,  in  the  house,  who  during  this  epidemic,  assisted  in  placing  in 
coffins,  and  burying  1500  victims  of  yellow  fever;  and  in  considera¬ 
tion  of  his  having  accomplished  so  unparalleled  an  office  of  danger 
and  humanity,  he  was  pensioned  with  a  little  extra  food  and  clothing. 
Here  was  a  man  possessed  of  a  wonderful  degree  of  faithful  forti¬ 
tude.  I  should  have  given  much  to  have  known  such  a  one;  for 
depend  upon  it,  had  such  a  nature  been  properly  understood,  it  could 
have  been  taken  by  the  hand,  and  conducted  into  some  nobler  sphere 
of  activity  and  duty,  than  is  usually  found  within  the  walls  of  a 
public  charity.  On  the  80th  of  December,  the  disease  having  dis¬ 
appeared,  the  doors  of  the  house  were  again  thrown  open  to  persons 
entitled  to  its  aid. 

The  managers,  after  witnessing  the  horrors  of  the  late  epidemic, 
had  become  exceedingly  sensitive  on  the  subject  of  what  they  con¬ 
sidered  as  contagious  diseases ;  and  in  1795,  when  the  city  board 
sent  to  the  institution  cases  of  dysentery,  which  was  then  prevailing 
both  in  the  wards  of  the  hospital  and  throughout  the  town,  they 
remonstrated  strongly  against  their  action. 

In  August  1798,  Doctors  Pleasants  and  Boyce  communicated 
to  the  managers  the  unwelcome  intelligence  of  the  re-appearance  of 
yellow  fever  in  the  city ;  and  asking  the  adoption  of  additional  pre¬ 
cautionary  measures  to  avoid  the  introduction  of  any  affected  person. 
The  steward  was  accordingly  directed  to  allow  no  admission  without 
a  certificate  from  one  of  the  attending  physicians.  The  subject  of 
ventilation  began  at  this  time  to  receive  some  attention.  The  win¬ 
dows  were  so  altered  as  to  lower  from  above,  and  I  may  add  here, 
in  passing,  that  this  subject  has  not  yet  been  exhausted,  even  in 
the  present  palatial  building.  Frequent  conferences  took  place  at 


43 


this  time  between  the  managers  and  the  board  of  health,  and  between 
the  former  and  the  managers  of  the  Marine  city  hospital,  with  a 
view  to  provide  accommodations,  and  sustenance  for  the  poor  of  the 
\  city  and  districts,  and  to  aid  such  persons  as  desired  to  move  from 

the  city  limits.  It  was  certainly  a  period  of  the  most  deplorable 
suffering  among  the  poor.  On  the  10th  of  September  1798,  they 
concluded  to  solicit  a  loan  on  subscription,  to  be  re-imbursed  out  of 
any  fund  afterwards  designated  by  the  Legislature.  During  the 
month  of  November,  between  two  and  three  hundred  children  utterly 
destitute,  were  sent  to  the  managers,  their  parents  having  fallen  vic¬ 
tims  to  the  fever.  Some  idea  may  be  formed  of  the  state  of  the  pub¬ 
lic  mind,  when  it  is  stated,  that  during  the  fever  of  1793,  17,000 
persons  fled  the  city;  and  during  that  of  1798,  50,000;  leaving  only 
something  over  3000  persons  in  Philadelphia;  and  that  from  August 
the  8th  to  October  the  3d  of  these  two  visitations,  4625  individuals 
fell  victims  to  the  disease.*  This  year  the  whooping  cough  prevailed 
to  an  unparalleled  degree ;  it  visited  almost  every  house,  and  in  order 
to  isolate  the  children,  Luke  Morris,  one  of  the  managers,  took  a 
house  some  distance  from  the  institution. 

In  July  1802,  great  apprehension  was  again  entertained  of  another 
visitation  of  the  fever.  The  doors  were  closed  against  the  admission 
of  any  paupers :  no  stranger  was  allowed  to  visit  the  house  :  the  use 
of  the  hearse  was  not  permitted  for  any  burial,  but  such  as  took 
place  from  the  institution  :  nor  were  the  resident  pupils  allowed 
to  visit  any  persons  in  the  city.  This  interdict  was  maintained  until 
the  8th  of  November,  and  whatever  influence  it  may  have  exerted, 
certainly  the  house  enjoyed  a  comparative  immunity  from  the  disease. 
Again,  in  September  1803,  another  alarm  prevailed,  in  consequence 
of  the  re-appearance  of  fever  in  the  city;  and  again  were  admis¬ 
sions  refused  except  to  the  officers  of  the  house.  The  board,  with 
the  consent  of  the  Governor  of  the  State,  took  the  Pennsylvania  Arse¬ 
nal  as  a  temporary  accommodation  for  the  poor.  They  afterwards 
procured  a  house  on  the  banks  of  the  Schuylkill  at  Race  street,  be¬ 
longing  to  Doctor  Curry,  which  was  supplied  with  twenty-five  bed¬ 
steads  and  bedding,  a  horse-cart,  and  other  necessary  appliances. 
This  proved  to  be  the  last  visit  which  the  Alms  house  received  from 
the  yellow  fever. 

During  the  month  of  August  1807,  an  epidemic  influenza  broke 
out  in  the  institution,  attacking  both  inmates  and  officers,  and  pre- 


*  Hazzard’s  Register  Penn.  Vol.  10,  p.  112. 


44 


vailed  in  so  violent  a  form,  and  so  general,  as  to  interrupt  the  ordi¬ 
nary  routine  of  business. 

The  health  of  the  institution  appears  after  this  to  have  been  gene¬ 
rally  good  until  1811.  In  August  of  that  year,  a  violent  type  of  f 

dysentery  made  its  appearance  in  the  wards,  and  proved  so  extensive 
and  malignant  that  the  board  had  many  of  the  worst  cases  carried 
out  of  the  house  and  quartered  in  a  barn,  which  stood  on  a  vacant 
piece  of  ground  near  by,  called  the  pasture  lots,  and  which,  it  ap¬ 
pears,  was  followed  almost  immediately  by  salutary  results. 

In  order  to  isolate  the  cases  of  small-pox  which  from  time  to  time, 
made  their  appearance,  a  house  was  taken  in  1815,  directly  opposite 
the  institution  on  Spruce  street,  into  which  such  patients  were  placed. 

The  Fall  of  1817  was  one  of  much  sickness,  distress  and  mortality 
in  the  Alms  house.  The  ordinary  diseases  of  the  house  all  tended  to 
assume  an  adynamic  type,  throughout  the  winter,  and  after  the  com¬ 
mencement  of  the  new  year  1818,  in  January,  typhus  fever  prevailed 
to  such  a  degree  as  to  invite  an  inquiry  into  the  sanitary  state  of  the 
wards,  from  the  board  of  health.  The  disease  commenced  about  the 
1st  of  November  1817,  and  as  near  as  I  can  ascertain,  up  to  January 
5th,  1818 — two  months — there  had  been  eighty-six  cases ;  sixteen 
had  died,  twenty  were  discharged,  fifty  remained,  and  twenty-five  of 
these  were  considered  to  be  convalescing.  "What  number  of  this  re¬ 
maining  fifty  died,  it  is  impossible  to  learn.  This  statement  was 
made  by  Doctor  James,  after  which  there  is  a  record  of  nine 
cases,  of  which  six  died.  By  February  the  number  and  malignacy 
of  the  cases  increased  to  such  an  extent,  the  managers  requested  the 
general  board  to  issue  no  more  admissions,  and  accordingly,  on  the 
28th,  the  latter  body  concluded  to  send  all  cases  of  undeveloped 
disease  to  the  quarantine  house,  until  their  character  was  declared ; 
which,  should  it  prove  typhus,  was  then  sent  to  the  sugar-house,  an 
old  building  which  stood  on  the  Alms  house  grounds,  contiguous  to 
the  institution.  It  was  about  this  time,  the  general  board  framed  an 
address  to  the  medical  officers,  asking  their  opinion  on  the  contagious¬ 
ness  of  the  fever  then  prevailing.  Their  answer  was  like  some 
oracular  response,  characterized  by  a  degree  of  caution  and  non-com¬ 
mittal  which  would  have  done  credit  to  the  most  adroit  politician  of 
1862  )  yet  it  might  be  gathered  from  the  counsel  which  they  gave,  { 

urging  the  u  separation  of  the  affected  from  the  others” — they  all  be¬ 
lieved  what  they  did  not  care  to  express.  Among  their  recommenda¬ 
tions  was  the  increase  in  both  the  quality  and  quantity  of  the  diet  for 
the  poor,  as  calculated  to  enable  these  helpless  beings  to  resist  mor- 


45 


bid  influences.  The  managers  thought  it  better,  however,  to  refuse 
this,  and  regale  them  by  the  highly  nutritious  and  stimulating  beve¬ 
rage  of  molasses,  ginger  and  water. 

In  1823  cases  of  small-pox  becoming  numerous,  it  was  thought  best 
to  take  the  hospital  at  Bush  Hill;  the  superintendance  of  which  was 
committed  to  Doctor  John  K.  Mitchell,  on  the  2nd  of  December  of 
that  year,  and  who  continued  to  discharge  his  duties  with  devotion, 
alike  creditable  to  the  goodness  of  his  heart,  and  his  well-known  pro¬ 
fessional  ability,  until  February  the  2nd  1824,  as  long  as  the  neces¬ 
sity  for  his  services  existed,  at  which  time  he  received  the  compli¬ 
mentary  thanks  of  the  board,  and  was  voted  a  piece  of  plate,  which 
his  son,  Doctor  S.  Weir  Mitchell,  informs  me,  was  a  pitcher  bearing 
an  appropriate  inscription. 

I  find  also,  a  report  containing  the  results  of  this  service,  and  from 
which  it  appears  there  were  one  hundred  aud  fifty-eight  persons  re¬ 
ceived  into  the  hospital.  Of  this  number,  one  hundred  and  fifteen 
cases  were  unprotected,  and  seventy  of  these  died  :  twenty-five  had 
been  vaccinated,  of  which  all  recovered  :  five  had  been  inoculated,  of 
which  two  died  :  four  had  suffered  a  previous  attack  of  small-pox, 
and  of  these  two  died,  and  of  the  remaining  nine  nothing  of  their 
previous  history  was  known.  Eighty- four  of  the  cases  occurred  in 
males,  of  which  forty-seven  died ;  seventy-four  in  females,  of  which 
thirty  died.  The  greatest  mortality  was  among  the  males,  and  curious 
as  it  may  seem,  the  fatality  among  those  previously  inoculated,  or  who 
had  had  variola,  was  greater  than  among  those  vaccinated.  On 
June  21st,  1824,  the  thanks  of  the  guardians  were  tendered  to 
Doctor  John  Bell,  who  was  associated  with  Doctor  Mitchell,  for  his 
humane  and  faithful  attention  to  such  as  labored  under  this  loathsome 
disease.  Doctor  Bell’s  name  continued  to  be  associated  with  the 
small-pox  hospital  until  very  recently,  when  it  was  closed. 

In  1827,  Doctor  Thomas  Brinkle  had  the  care  of  this  hospital. 
A  report  was  made  in  September  of  that  year,  from  which  it  would 
appear  there  were  received  one  hundred  and  seventy-six  patients; 
sixty-one  of  whom  died,  and  one  hundred  and  fifteen  recovered.  In 
eighteen  of  these  cases  the  patients  had  passed  through  a  previous 
attack,  three  of  whom  died ;  fifty-three  cases  had  been  previously 
vaccinated,  and  eight  died ;  a  result  corroborating  the  report  of 
Doctor  Mitchell,  and  tending  to  establish,  what  I  believe  is  at  the 
present  asserted,  that  vaccination  is  a  better  protective  than  either 
inoculation  or  variola  itself.  As  early  as  1818,  the  subject,  of  erect¬ 
ing  a  building,  or  pest-house,  as  it  was  termed,  had  been  agitated  by 


46 


the  board,  and  while  it  was  the  conviction  of  a  majority  of  the  mem¬ 
bers,  that  the  matter  of  providing  for  contagious  diseases  did  not 
legitimately  belong  to  the  guardians,  yet,  as  a  necessity,  the  con¬ 
struction  of  such  a  building  was  recommended.  On  the  5th  of  ^ 

June  1835,  a  resolution  to  the  same  effect  was  passed,  but  was  never 
carried  into  effect,  while  the  Alms  house  stood  on  the  east  side  of 
the  Schuylkill,  the  old  sugar-house  being  used  for  that  purpose.  In 
1841,  however,  after  consultation  with  the  medical  board,  a  site  was 
selected  on  the  west  side  of  this  institution,  on  which  a  building 
was  erected  and  called  the  outer  hospital,  into  which  cases  of  an  in¬ 
fectious  nature  were  placed.  This  was  afterwards  occupied  as  the 
residence  of  the  physician-in-chief,  having  been  moved  in  its  totality 
to  its  present  situation  on  the  Darby  road,  at  the  very  trifling  cost  of 
about  $2100,  and  is  now  occupied  by  Doctor  Butler,  the  physician 
in  charge  of  the  lunatic  department.  To  provide  for  cases  of  small¬ 
pox,  the  guardians  have  been  in  the  habit  of  using  the  old  mansion 
house,  between  the  institution,  and  the  gate  of  entrance  from  the 
Darby  road.  The  liability  of  the  board  of  health  to  take  care  of 
cases  of  small-pox,  has  been,  and  I  believe  still  continues  to  be  a 
point  on  which  a  wide  difference  of  views  exist.  In  1850  the  solici¬ 
tor  of  the  board  of  guardians  was  requested  to  frame  a  petition  to 
the  legislature,  praying  that  their  body  might  be  relieved  of  this 
duty;  still  in  1852  an  act  was  passed  giving  to  the  board  of  health 
the  right  to  charge  three  dollars  a  week  for  every  case  of  contagious 
disease,  for  which  their  body  provided.  The  hospital  on  Islington 
lane  haviug  been  closed  on  the  1st  of  April  1860,  strange  as  it  may 
appear,  in  a  community  proverbial  for  its  wise  and  liberal  provisions 
for  almost  every  species  of  physical,  moral,  and  mental  destitution 
and  suffering ;  Philadelphia  is  to-day  without  a  public  place  where 
either  citizen  or  alien  could  command  the  services  of  physician  or 
nurse,  if  overtaken  by  contagious  disease. 

In  1832  Philadelphia  was  visited  by  the  cholera,  which  produced 
a  degree  of  alarm  only  equalled  by  that  of  the  yellow  fever  in  1793 
and  1798.  In  July  the  medical  staff  advised  the  non-reception  of 
cases,  and  an  immediate  provision  for  such  as  occurred  within  their 
jurisdiction  outside  of  the  house.  The  physicians  to  the  out-door 
poor  held  a  meeting,  at  which  Dr.  Condie  presided,  and  recommended  | 

the  establishment  of  temporary  hospitals,  to  be  placed  under  their 
care,  and  receive  all  such  cases  as  were  not  thought  proper  subjects 
for  admission  to  the  Alms  House.  At  that  time  the  present  house 
was  in  process  of  erection,  the  present  lunatic  department  being 


47 


almost  completed.  About  tbe  21st  of  July  a  case  appeared  in  the 
infirmary  of  the  institution,  then  in  charge  of  Dr.  Hodge,  and  it 
was  at  once  resolved  to  remove  all  the  healthy  paupers  over  the  river 
H  to  the  West  building,  designed  then  for  the  hospital,  and  these  were 

the  first  occupants  of  the  new  institution.  The  guardians  next  made 
application  to  Commodore  Baron  for  the  privilege  of  moving  others, 
still  remaining,  into  the  Naval  Asylum,  but  which  was  declined,  as 
the  commodore  did  not  feel  himself  authorized  to  allow  its  occupa¬ 
tion  by  the  civil  authorities,  other  than  as  a  hospital.  A  subsequent 
resolution  empowered  the  President  of  the  Board  of  Guardians — Mr. 
Lippincott — with  the  Mayor  of  the  city,  to  arrange  for  the  admission 
of  a  number  of  their  cholera  patients  into  this  asylum.  In  the 
house  the  cases  increased  daily,  until  a  general  panic  took  place. 
Nurses  became  clamorous  for  an  increase  of  wages,  and  it  was  granted. 
These,  between  terror  and  a  want  of  moral  sense,  were  seized  with  a 
kind  of  mad  infatuation.  They  drank  the  stimulants  provided  for 
the  sick,  and  in  one  ward,  where  the  pestilence  raged  in  its  most 
fearful  forms,  and  where  between  the  dead  and  the  dying  the  sight 
was  most  appaling,  these  Furies  were  seen  lying  drunk  upon,  or 
fighting  over,  the  dead  victims  of  the  disease.  Persons  rescued 
from  shipwreck  have  furnished  histories  of  some  very  singular 
mental  phenomena,  the  product  of  utter,  hopeless  despair,  disar¬ 
ranging  the  complex  machinery  of  the  intellectual  and  emotional 
organization,  so  that  while  the  great  hulk,  freighted  with  living  souls, 
was  settling  down  into  its  grave  of  waters,  some  would  laugh  as 
though  in  an  ecstacy  of  joy,  and  others  command,  in  vehement  tones 
of  authority,  the  billows  to  roll  back,  and  the  tempest  to  hush.  We 
call  all  such  extravagant  exhibitions  hysterical,  but  the  mental  and 
physical  re-actions  are  none  the  less  curious  to  either  the  metaphy¬ 
sician  or  the  psychologist.  In  this  state  of  disorder,  application  was 
made  to  Bishop  Kendrick  for  Sisters  of  Charity.  The  request  was 
granted,  and  these  devoted  ministers  of  mercy,  at  once  entered  on 
their  mission  of  danger,  restoring  order  and  diffusing  hope  by  the 
calm  and  self-composed  manner  with  which  they  moved  among  the 
diseased.  These  sisters  remained  at  their  post  until  the  20th  of 
May  1833.  During  the  epidemic,  the  utmost  attention  was  given 
to  the  study  and  treatment  of  the  disease.  Doctor  Hodge  informed 
me,  that  at  the  suggestion  of  Doctor  Horner,  the  saline  solution  was 
thrown  into  the  veins,  in  order  to  provide  for  the  blood  lesion  which 
was  alleged  by  several  prominent  authorities  to  exist,  but  in  no  case 
were  any  good  results  obtained.  Large  double  tin  cases  were  like- 


48 


wise  constructed,  in  which  the  patients  were  placed,  while  external 
warmth  was  communicated  by  filling  the  interval  between  the  case 
and  its  metallic  lining  with  hot  water.  Little  if  any  benefit  was 
experienced  from  this  mechanism.  i 

In  1849  the  cholera  returned,  and  in  July  a  meeting  was  called 
by  the  Mayor,  to  consult  on  the  best  measures  for  the  exigency  again 
likely  to  be  forced  on  the  community.  This  meeting  took  place  at 
the  office  in  the  city,  and  was  attended  by  Doctors  Benedict  and 
Page,  from  the  institution;  and  Doctors  Harris,  Meigs,  Pearce,  and 
Dillingham,  of  the  city.  The  Board  of  Guardians,  after  receiving 
all  the  light  possible  from  an  interchange  of  views,  concluded  to 
appoint  a  committee  to  carry  out  any  suggestions  made  by  the  medi¬ 
cal  officers  of  the  house.  The  cases  increased  rapidly  in  the  insti¬ 
tution.  The  wash-house,  which  stands  in  the  centre  of  the  hollow 
square,  was  occupied  at  first  as  a  cholera  hospital,  and  I  remember 
well  of  passing  through  that  building,  and  witnessing  with  sad 
interest,  the  poor  victims  in  every  stage  of  the  disease.  It  was  an 
excessively  hot  day,  yet  they  were  all  as  cold  as  a  block  of  ice,  and 
the  lines  of  death  were  legibly  traced  on  every  face.  Doctor  Mas- 
senburg,  from  Hampton,  Virginia,  was  appointed  temporary  resident 
of  the  hospital  at  this  time,  a  most  amiable  and  intelligent  gentle¬ 
man,  one  of  the  first  medical  acquaintances  I  made  after  coming  to 
the  city.  He  was  attacked  with  the  disease  while  absent  a  few  hours 
on  a  visit  to  the  town,  and  died  in  great  agony,  notwithstanding  the 
most  untiring  efforts  were  made  in  his  behalf. 

The  earliest  case  of  the  disease  in  the  house  was  on  the  27th  of 
June  1849.  A  colored  man,  William  Jones,  was  brought  into  the 
black  medical  from  the  city  on  that  day,  and  died  before  night.  The 
second  case  was  likewise  a  negro,  Isaac  Wood,  brought  from  the 
city  on  the  29th,  and  died  the  same  day.  Between  this  date  and  the 
1st  of  July  nine  other  cases  occurred.  At  this  time  the  second 
story  of  the  building,  called  the  wash-house,  was  arranged  for  a  hos¬ 
pital,  and  the  patients  conveyed  there  as  soon  as  attacked.  For 
several  days  after  this,  the  cases  were  so  numerous  and  fatal,  that  in 
the  alarm  and  confusion  no  register  of  admissions  was  kept.  After 
the  7th  of  July  there  is  an  account  of  ninety-nine  males  admitted, 
eighty-seven  of  whom  died;  and  one  hundred  and  one  females,  ninety 
of  whom  died.  On  the  13th,  the  medical  attendants  recommended 
the  erection  of  two  temporary  hospitals  outside  of  the  walls.  The 
workmen  commenced  the  16th,  and  by  the  23d  had  up  two  board 
tents  in  the  field  by  the  gate  as  you  enter  the  lane  from  the  Darby 


49 


road.  They  were  occupied  the  same  day  by  twenty  males  and 
eight  females.  Of  the  former,  seventeen  died ;  of  the  latter,  three 
died.  Sixty-eight  additional  cases  were  treated  in  the  tents,  of 
which  number  thirty  died.  From  these  data,  which  from  personal 
observation  I  believe  to  be  far  short  of  the  truth,  the  total  number 
of  cases  were  307,  and  the  deaths  229.*  The  disease  disappeared 
about  the  20th  of  August,  at  which  time  these  provisional  hospitals 
were  taken  down.  During  much  of  this  time  the  guardians  could  not 
raise  a  quorum  for  the  transaction  of  business,  but  no  record  remains 
of  any  medical  officer  having  left  his  post,  except  poor  Massenburg, 
the  stranger,  who  was  called,  I  hope,  from  probation  to  fruition. 

The  Sanitary  Committee  of  the  Board  of  Health,  under  the  im¬ 
pression  the  virulence  of  the  disease  in  the  hospital  was  due  to  an 
improper  diet,  sent  a  communication  to  the  Board  on  that  subject. 
The  statements  made  in  their  answer  showed  that  any  trifling  im¬ 
propriety  of  this  nature  had  little  to  do  with  its  prevalence.  The 
mode  of  burying  the  dead  was  changed  for  a  time.  Trenches  were 
dug  so  as  to  hold  only  four  coffins,  two  abreast,  and  twenty-four 
inches  apart.  This  space  was  filled  in  with  dirt,  twenty-five  pounds 
of  chloride  of  lime  were  added  to  each  grave,  and  the  whole  covered 
with  four  feet  of  earth. 

In  1854  a  third  epidemic  of  cholera  prevailed.  It  commenced  on 
the  7th  of  July,  and  attained  its  greatest  fatality  the  last  days  of 
this  month  and  the  beginning  of  August.  Straggling  cases  of  it 
appeared  as  late  as  the  7th  of  November.  During  this  period  there 
were  about  300  cases,  most  of  which  were  treated  in  the  small-pox 
hospital,  near  the  gate,  with  the  addition  of  a  wooden  tent.  On 
examining  the  sources  calculated  to  throw  light  on  the  result,  it 
would  appear  150  cases  of  the  number  attacked  proved  fatal. 

During  the  months  of  January  and  February  1849,  a  very  fatal 
epidemic  of  puerperal  fever  prevailed  in  the  lying-in  department  of 
the  house.  I  have  not  been  able  to  ascertain  the  number  of  cases, 
but  am  told  by  a  very  reliable  and  intelligent  nurse  of  the  house, 
that  almost  all  attacked,  died.  For  four  weeks  the  wards  were 
vacated,  and  every  means  used  to  disinfect  the  place. 

In  1855  the  disease  again  appeared,  and  lingered  in  the  wards  for 
three  months,  carrying  off  almost  all  puerperal  women  attacked. 
Doctor  Penrose,  who  has  some  valuable  tables  in  course  of  prepara¬ 
tion,  informs  me  that  there  have  been  cases  of  this  formidable  dis¬ 
ease  in  the  obstetrical  department  every  year,  from  5841  to  1858, 

*  A  careful  examination  made  after  writing  the  above,  shows  255  deaths 
to  have  taken  place. 


50 


except  the  years  1844  and  1845  ;  and  that  since  the  change  in  the 
medical  administration  of  the  institution,  he  is  not  cognizant  of  a 
single  case  having  occurred.  This  exemption  he  attributes  to  the 
sanitary  measures  advised  by  himself  and  colleagues. 

The  Children's  Asylum  has  often  been  invaded  by  destructive 
epidemics.  The  first  one  recorded  was  in  April  1835,  the  year  after 
the  children  were  moved  to  the  present  house.  This  was  the  can - 
crum  oris.  That  the  mortality  was  large  may  be  inferred  from  a 
single  allusion,  in  which  it  is  stated  twenty  children  had  died  in  nine 
days  from  the  disease.  The  existence  of  the  affection,  and  the 
fatality,  was  in  a  great  measure  due  to  the  very  imperfect  organiza¬ 
tion  of  the  department.  Doctor  Hodge,  who  declined  this  year 
longer  to  attend  the  asylum,  addressed  the  managers  on  this  subject, 
advising,  as  an  act  of  imperative  humanity,  an  immediate  attention 
to  the  interests  of  this  department.  Among  the  suggestions  made, 
were  the  appointment  of  a  resident  physician  exclusively  for  the 
Asylum,  the  selection  of  experienced  and  conscientious  nurses,  more 
room  and  ventilation,  and  more  hospital  conveniences. 

The  other  diseases  peculiar  to  this  period  of  life,  which  have  fre¬ 
quently  from  that  time  to  the  present  existed,  are  opthalmia,  measles, 
and  scarlet  fever. 

On  the  26th  of  November  1804,  the  Managers  arranged  for  the  first, 
a  Diet  Table  for  the  use  of  the  house.  By  this  table,  every  pauper 
in  the  Medical,  Surgical,  and  Incurable  Wards,  was  allowed  for 


BREAKFAST. 

One  pint  of  Coffee  or  one  pint  of  Chocolate.  J  lb.  of  Bread. 

DINNER. 

1  lb.  of  Meat.  1  pint  of  Soup.  1  lb.  of  Potatoes.  £  lb.  of  Bread. 

SUPPER. 

1  pint  of  Tea.  J  lb.  of  Bread. 

Every  other  pauper  on  Sunday,  Tuesday  and  Thursday,  received: 


BREAKFAST. 

1  pint  of  Coffee  or  1  pint  of  Chocolate.  £  lb.  of  Bread. 

DINNER. 

1  lb.  of  Bread.  J  lb.  of  Meat.  1  pint  of  Soup.  1  lb.  of  Potatoes. 

SUPPER. 

i  lb.  of  Bread.  1  pint  of  Tea. 

Every  pauper  on  Monday  received  : 


BREAKFAST. 

1  pint  of  Coffee  or  1  pint  of  Chocolate. 

DINNER. 

1  lb.  of  Potatoes.  1  qt.  of  Hash. 

SUPPER. 

1  pint  of  Tea. 

On  Wednesday  and  Friday: 


\  lb.  of  Bread. 
£  lb.  of  Bread. 
1  lb.  of  Bread. 


BREAKFAST. 

1  pint  of  Coffee  or  1  pint  of  Chocolate.  |  lb.  of  Bread. 

DINNER. 

Mush  at  pleasure — 3  gills  of  Molasses  to  10  persons. 


51 


SUPPER. 

1  pint  of  Tea.  £  lb.  of  Bread. 

For  the  Lying-in  Wards  every  day  in  the  Week : 

BREAKFAST. 

J  lb.  of  Bread.  1  qt.  of  Coffee  or  Chocolate. 

DINNER. 

1  lb.  of  Bread.  1  lb.  of  Potatoes.  Meat  as  ordered  by  physician. 

SUPPER. 

1  lb.  of  Bread.  1  qt.  of  Tea. 

In  this  table  there  is  a  fair  amount  of  food  to  each  person,  but 
very  little  variety.  There  is  no  subject  connected  with  the  admin¬ 
istration  of  an  institution  of  this  kind  which  is  more  important  than 
the  one  under  consideration.  It  is  adopted  by  many  as  a  foregone 
principle,  that  the  objects  of  public  charity  should  be  confined  to  the 
simplest,  plainest,  coarsest  kind  of  fare,  in  quality;  and  in  quantity  as 
moderate  as  may  be  consistent  with  their  needful  support.  (I  may 
add  here,  in  a  parenthesis,  that  I  do  not  make  any  charge  of  such 
views  against  the  Board  of  Guardians.)  Connected  with  this  snb- 
ject,  I  conceive  there  are  very  nice  questions  of  moral  ethics  and 
political  science  involved.  I  presume,  both  as  regards  clothing  and 
food,  the  justification  is  drawn  from  the  fact  that  the  inmates  of 
these  public  charities  are  compelled  to  seek  a  refuge  in  consequence 
of  their  misfortunes  being  self-inflicted,  the  result  of  their  own  vices 
and  evil  habits,  and  therefore  they  surrender  any  claims  to  the  pro¬ 
tection  of  society  beyond  those  of  bare  support.  This  is  not  the 
place  to  discuss  a  subject  of  such  ample  nature.  Let  me  only  throw 
out  a  few  thoughts  in  passing  which  may  aid  us  somewhat  in  its 
proper  treatment.  What  is  it  which  makes  us  to  differ  from  the 
most  degraded  inmates  of  this  house?  Nothing;  really  nothing 
but  the  grace  of  God.  Will  any  one  doubt  that  the  chief  instru¬ 
mentalities  concerned  in  giving  him  position,  reputation,  moral  and 
social  standing  in  society,  were  the  influential  operations  of  parental 
care  and  tenderness,  extended  during  those  years  when  the  human 
character  is  as  plastic  as  the  clay  in  the  hands  of  the  potter,  and 
still  later,  where  the  forecast  of  friends  had  provided  for  personal 
comfort,  and  aided  in  the  formation  of  associations,  salutary  and  re¬ 
straining.  These,  gentlemen,  more  than  any  natural  endowments, 
have  made  you  what  you  are.  Now  look  at  the  other  side  of  the 
picture.  The  vast  proportion  of  the  inmates  of  this  house  have 
never  enjoyed  such  all-controlling  agencies.  Born,  most  of  them, 
in  humble  life,  with  perhaps  a  vicious  training,  thrown  on  the  world 
to  their  own  resources  during  the  most  impressible  period  of  ex¬ 
istence,  with  unformed  characters,  called  to  struggle  with  all  the 
temptations  incident  to  a  life  of  obscure  toil  and  want,  and  without 


52 


the  sympathy  of  either  man  or  government,  is  it  a  marvel,  that  with 
such  a  moral  organization  as  the  race  carries  with  it,  these  creatures 
should  be  driven  to  shipwreck  by  the  tempests  which  come  up  from 
the  human  heart?  These  considerations  at  least  commend  them  to 
our  generous  sympathy  and  charity,  and  to  this  end,  God  has  wisely 
implanted  in  the  human  heart  a  principle  to  compassionate  misery 
and  misfortune  in  all  their  multiform  aspects.  Whenever,  therefore, 
disease  or  decrepitude,  either  of  body  or  mind,  the  result,  though  it 
may  be  of  vicious  habits,  compel  such  to  seek  an  asylum  at  the  hands 
of  their  fellow-beings,  whatever  other  claims  they  may  have  forfeited 
from  law  and  society,  that  to  the  support  of  life  they  have  not.  The 
diet,  therefore,  it  would  seem  reasonable,  should  be  in  quality, 
quantity,  and  variety,  such  as  is  capable  of  maintaining  the  best 
possible  health,  consistent  with  a  broken-down  constitution.  The 
diet  should  be  determined  after  a  careful  study  of  the  constitutional 
characteristics  of  the  population,  prevailing  diseases,  and  their  usual 
complications.  Looking  at  the  subject  in  an  economical  point  of 
view,  that  regimen  will  prove  the  most  desirable  which  exerts  the 
largest  influence  in  keeping  the  inmates  out  of  the  hospital,  as  by 
the  report  for  1862  it  will  conserve  the  difference  between  seventy- 
two  cents  and  two  dollars. 

In  conclusion,  gentlemen,  it  is  difficult  to  over-estimate  the  im¬ 
portance  of  this  institution,  to  either  the  profession  or  the  com¬ 
munity.  To  say  nothing  of  the  multiform  types  of  destitution  and 
want  which  it  meets  and  relieves,  look  at  the  field  which  it  offers  to 
the  disciple  of  medicine,  and  which  no  man  will  lightly  esteem,  who 
contemplates  the  prosecution  of  his  profession  with  a  conscience  void 
of  offence  towards  God  and  man.  There,  is  a  Hospital,  in  which  over 
eight  thousand  cases  of  disease  are  treated  annually;  a  Children's 
Asylum,  offering  illustrations  of  all  the  complaints  incident  to  this 
period  of  life;  and  there,  is  an  Obstetrical  department,  in  which  as 
many  as  seven  cases  of  labor  have  occurred  in  twenty-four  hours, 
and  where  in  the  last  thirteen  years,  over  two  thousand  six  hundred 
children  have  been  born.  One  year  industriously  spent  in  this  in¬ 
stitution,  will  yield  in  medical  experience,  the  fruits  of  ten  years 
gathered  from  an  ordinary  private  practice.  Or  to  place  the  state¬ 
ment  in  another  form,  a  graduate  of  medicine,  faithfully  improving 
for  a  single  year  his  opportunity  for  the  study  of  disease  in  the 
wards  of  the  Philadelphia  hospital,  will  be  better  fitted  to  assume  the 
responsibilities  of  his  profession,  than  one  who  labors  ten  years  in  an 
ordinary  city  or  country  practice. 


